Local Recurrence after Curative Resection of Rectal Cancer in Relation to Various Factors

Abstract

To analyze the relationship between local recurrence and various clinical and pathological features, 339 cases who had undergone curative surgery for rectal cancer during 10 year period were reviewed. Dukes stage, especially extent of lymph node metastasis, and grade of histologic differentiation are associated with risk of local recurrence. Tumor size (5 ern .>, 5 em <) and location (upper, mid, low), duration of symptom (6 month .>, 6 month - 1 year, 1 year <) and presence or absence of obstructive symptom are not associated with risk of local recurrence. To determine the adequate minimal length of distal resection of nonual lookinq rectum, rate of local recurrence and survival of the cases who had undergone sphincter saving operation were analysed according to the length of distal resected rectum (2 ern .>, 2-5 em, 5 cm <). The result shows that to reduce local recurrence, especially anastomotic recurrence, after sphincter saving operation, at least 2 cm of distal rectum should be resected and this is more true in the cases without lymph node metastasis.