Journal of Gastrointestinal Surgery

, Volume 19, Issue 6, pp 1123–1131 | Cite as

Impact of Anatomic Location on Locally Recurrent Rectal Cancer: Superior Outcome for Intraluminal Tumour Recurrence

  • Johannes Klose
  • Ignazio Tarantino
  • Thomas Schmidt
  • Thomas Bruckner
  • Yakup Kulu
  • Tobias Wagner
  • Martin Schneider
  • Markus W. Büchler
  • Alexis UlrichEmail author
Original Article



Local recurrence of rectal cancer after curative surgery predicts patients’ prognosis. The correlation between the exact anatomic location of tumour recurrence and patients’ survival is still under debate. Thus, this study aimed to investigate the impact of the exact location of recurrent rectal cancer on post-operative morbidity and survival.


This is a retrospective study including 90 patients with locally recurrent rectal cancer. The location of tumour recurrence was classified into intraluminal and extraluminal recurrence. Univariate and multivariable Cox regression analyses were used to determine the impact on post-operative morbidity and survival.


Patients’ survival with intraluminal recurrence was significantly longer compared to patients with extraluminal recurrence (p = 0.027). Curative resection was associated with prolonged survival in univariate and multivariable analyses (p = 0.0001) and was more often achieved in patients with intraluminal recurrence (p = 0.024). Survival of curative resected patients with intraluminal recurrence was significantly longer compared to curatively resected patients with extraluminal recurrence (p = 0.0001). The rate of post-operative morbidity between intraluminal and extraluminal recurrence was not statistically different (p = 0.59).


Based on the present investigation, intraluminal recurrence is associated with superior outcome. Post-operative morbidity did not differ significantly between both groups.


Rectal cancer Local tumour recurrence Post-operative morbidity Survival 



Abdominoperineal resection


Confidence interval


Hazard ratio


Intraoperative radiotherapy


Total mesorectal excision


Tumour node metastasis


Union for International Cancer Control


Grant Support


Conflict of Interest

The authors have nothing to disclose.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Johannes Klose
    • 1
  • Ignazio Tarantino
    • 1
  • Thomas Schmidt
    • 1
  • Thomas Bruckner
    • 2
  • Yakup Kulu
    • 1
  • Tobias Wagner
    • 1
  • Martin Schneider
    • 1
  • Markus W. Büchler
    • 1
  • Alexis Ulrich
    • 1
    Email author
  1. 1.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany
  2. 2.Institute for Medical Biometry and InformaticsUniversity of HeidelbergHeidelbergGermany

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