Abstract
Is the observed recurrence rate after curative surgery for rectal cancer always a good measure of therapeutic improvements? In an attempt to answer this question, the rates of local and distant recurrences were studied in two complete series of patients operated on for cure for rectal carcinoma. One hundred one consecutive patients were followed for five years in one series and 231 were followed for at least 18 years in the other series. The recurrence rate in the first series was 39 percent and in the second, with the longer observation time, 54 percent. The local recurrence rates were 24 and 38 percent, respectively. Both local and total recurrence rates increased with the length of the follow-up period. This was especially true for patients with combined local and distant disease. Autopsy sometimes demonstrated recurrences, clinically undiscovered. It is concluded that completeness, long follow-up, and intensive search for recurrence, including a high autopsy rate, are factors that raise both total and local recurrence rates. All these factors are important to consider when comparing results of different treatment modalities.
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References
Goligher JC. Neoplasms: surgical treatment. Curr Opinion Gastroenterol 1985;1:41–50.
Floyd CE, Corley RG, Cohn I Jr. Local recurrence of carcinoma of the colon and rectum. Am J Surg 1965;109:153–9.
Gilbertsen VA. Adenocarcinoma of the rectum. Arch Surg 1960;80:143–51.
Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1986;1:1479–82.
Williams NS. The rationale for preservation of the anal sphincter in patients with low rectal cancer. Br J Surg 1984;71:575–81.
Lasson ÅL, Ekelund GR, Lindström CG. Recurrence risk after stapled anastomosis for rectal carcinoma. Acta Chir Scand 1984;150:85–9.
Berge T, Ekelund G, Mellner C, Pihl B, Wenckert A. Carcinoma of the colon and rectum in a defined population. Acta Chir Scand 1973;suppl 438:11–86.
Gunderson LL, Dosoretz DE, Hedberg SE et al. Low-dose preoperative irradiation, surgery, and elective postoperative radiation therapy for resectable rectum and rectosigmoid carcinoma. Cancer 1983;52:446–51.
Weiss RB, DeVita VT Jr. The dilemma regarding postoperative chemotherapy in primary carcinoma of the colon. Surg Gynecol Obstet 1979;149267–71.
Enker WE, Laffer UT, Block GE. Enhanced survival of patients with colon and rectal cancer is based upon wide anatomic resection. Ann Surg 1979;190:350–7.
Deddish MR, Stearns MW Jr. Anterior resection for carcinoma of the rectum and rectosigmoid area. Ann Surg 1961;154:961–6.
Cass AW, Million RR, Pfaff WW. Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum. Cancer 1976;37:2861–5.
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Read at the XIth Biennial Congress of the International Society of University Colon and Rectal Surgeons, Dallas, Texas, May 4 to 8, 1986.
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Carlsson, U., Lasson, Å. & Ekelund, G. Recurrence rates after curative surgery for rectal carcinoma, with special reference to their accuracy. Dis Colon Rectum 30, 431–434 (1987). https://doi.org/10.1007/BF02556491
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DOI: https://doi.org/10.1007/BF02556491