Cancer of the rectum ten to twenty years after treatment

Summary and Conclusions

The case records of 369 patients (of an original 1,786) who lived more than ten years following initial treatment for cancer of the rectum have been analyzed: 265 patients were alive and well after 15 years, 147 after 20 years, and 47 after 25 years. Very few died of recurrent rectal cancer beyond the first decade following initial treatment.

Metachronous polyps developed in only 6.3 per cent of the 309 patients who could be followed for this long period. However, subsequent new colonic cancers developed in 17 (5.4 per cent) of these patients; 13 developed the second cancers during the second decade after the original treatment.

Noncolonic cancers also appeared in 9.5 per cent of these 309 patients, an incidence far greater than that in the general population.

Nine per cent of the 309 patients required surgical repair of paracolostomy hernias.

The overall survival rates for 551 patients at the 5-, 10,- 15-, and 20-year levels, tabulated from the stand-point of Dukes’ classification, are presented, and reconfirm a mortality attrition due more to other causes than to recurrent rectal cancer.