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KMID : 0356720120280020100
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Journal of the Korean Society of Coloproctology
2012 Volume.28 No. 2 p.100 ~ p.107
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Oncologic Outcomes and Risk Factors for Recurrence after Tumor-specific Mesorectal Excision of Rectal Cancer: 782 Cases
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Kim Sam-Hee
Bae Ki-Beom
Kim Jung-Min
Shin Jae-Ho
An Min-Sung
Ha Tae-Geun
Ryu Sung-Mok
Kim Kwang-Hee
Kim Tae-Hyeon
Choi Chang-Soo
Shin Jin-Yong
Oh Min-Kyung
Baek Seung-Hun
Hong Kwan-Hee
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Abstract
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Purpose: The aim of this study was to analyze the oncologic outcomes and the risk factors for recurrence after a tumor-specific mesorectal excision (TSME) of resectable rectal cancer in a single institution.
Methods: A total of 782 patients who underwent a TSME for resectable rectal cancer between February 1995 and December 2005 were enrolled retrospectively. Oncologic outcomes included 5-year cancer-specific survival and its affecting factors, as well as risk factors for local and systemic recurrence.
Results: The 5-year cancer-specific survival rate was 77.53% with a mean follow-up period of 61 ± 31 months. The overall local and systemic recurrence rates were 9.2% and 21.1%, respectively. The risk factors for local recurrence were pN stage (P = 0.015), positive distal resection margin, and positive circumferential resection margin (P < 0.001). The risk factors for systemic recurrence were pN stage (P < 0.001) and preoperative carcinoembryonic antigen level (P = 0.005). The prognostic factors for cancer-specific survival were pT stage (P < 0.001), pN stage (P < 0.001), positive distal resection margin (P = 0.005), and positive circumferential resection margin (P = 0.016).
Conclusion: The oncologic outcomes in our institution after a TSME for patients with resectable rectal cancer were similar to those reported in other recent studies, and we established the risk factors that could be crucial for the planning of treatment and follow-up.
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KEYWORD
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Rectal neoplasms, Colorectal cancer recurrence, Oncologic outcome, Tumor-specific mesorectal excision
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