Effect of total mesorectal excision and preoperative chemoradiotherapy on local recurrence in rectal cancer

Abstract

To investigate the effect of total mesorectal excision(TME) and preoperative therapy on local recurrence in rectal cancer. Rectal cancer patients who received TME in School of Oncology, Peking University, from January 2000 to August 2004 were enrolled in the study group. Patients who received surgical resection for rectal cancer from January 1996 to December 1999,before the introduction of TME,were chosen as controls. Postoperative complications and local recurrence were compared. Clinicopathological and follow- up data were analyzed. There were 161 patients in the TME group and 173 as controls. The intra- operative blood loss was significant less,hospital stay shorter,and lymph nodes harvested more in TME group than those in the control group,there was no difference in complication rate between the two groups. Local recurrence (LR) rate was 2.5% in TME and 8.0% in the control group, respectively (chi2=5.144; P=0.023). In TME group,the local recurrence rate was 1.8% in the 77 patients with preoperative therapy,and 2.9% in the other patients without preoperative therapy (P=0.182). Logistic regression analysis revealed that TME and vessel cancerous emboli were major risk factors for local recurrence of rectal cancer. TME and vessel cancerous emboli are major risk factors for local recurrence of rectal cancer.