Background:
@EN Pelvic and local recurrences of rectal cancers may be the result of inadequate surgery.
@ES Purpose:
@EN The aim of this study was to assess the risk factors of pelvic recurrences such as patient selection factors, acceptability of distal resection margins, perineural or angioinvsion, lymph node metastases, sphincter preservation.
@ES Method:
@EN The patients who had surgical resection for the rectal cancers which were within 11cm from the anal verge were used for this study. The patients also had postoperative adjuvant treatment with 5FU and leucovorin for 18 months. For the Dukes,
stage C2
cancers, postoperative adjuvant radiation therapies were applied.
@ES Results:
@EN Between 1985 and 1994, 70 patients (40 male, 30 female) had surgical rectal resections with a median follow-up period of 24 months. The stages of the tumors were A:B1:B2:C1:C2:D = 4:10:22:1:26:7, respectively. There were 27 cases of
recurrences
(38.6% of all patients) which included the recurrences within pelvis (33.3% of all recurrences), those with pelvis and distant metastases(25.9% of all recurrences), those with distant metastases and without pelvis involvement (40.7% of all
recurrences).
The significant risk factors for pelvic recurrences among the factors of patients, tumor and treatment were angio/lymphatic invasion, T-stage and choose of operation methods(LAR vs APR). But we could not find any significant differences among
sexes,
sizes of tumors, distances from anal verge, length of distal resection margins.
@ES Conclusion:
@EN The tumor factors such as angio/lymphatic invasion, the depth of tumor, lymph node of tumor-positive were more critical for pelvic recurrences than other patient factors. This date supports the conclusion that good evaluation of tumor factors
would
make it possible to predict the prognosis of the mid- and lower rectal cancers, and to have aggressive treatment modality.
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