Factors Predicting Local Recurrence in Rectal Cancer after Curative Surgery

Abstract

Purpose. The aim of this study was to identify possible clinicopathological predictor of local recurrence (LR) of Stage I-III rectal cancer in patients undergoing curative resection without pre-operative neoadjuvant concurrent chemo-radiotherapy.Methods. Between May 2005 and December 2008, a total of 178 patients with Stage I-III rectal cancer who had undergone curative resection and received regular follow-up were retrospectively analyzed. Possible clinicopathological risk factors of rectal cancer LR were analyzed using univariate and multivariate methods.Results. Postoperative LR was found in 25 (14%) patients. Univariate analysis indicated LR to be significantly correlated with lesion location (p = 0.046), vascular invasion (p = 0.001), perineural invasion (p = 0.001), high pre-operative carcinoembryonic antigen (CEA) level (p ＜ 0.001), depth of invasion (p = 0.047), nodal invasion (p = 0.008), distal resection margin ＜ 1 cm (p = 0.001), and distal resection margin ＜ 2 cm (p = 0.025). Multivariate analysis revealed LR to be significantly correlated with high pre-operative CEAlevels (p = 0.001) and distal resection margin ＜ 1 cm (p = 0.030).Conclusions. The results of this study suggest that pre-operative CEA level and distal resection margin ＜ 1 cm are important independent predicative factors for the development of the LR of rectal cancer after curative resection. Close follow up of these high-risk patients and intensive treatment after curative resection may be indicated.