Pelvic Recurrence Following Surgical Treatment of Rectal Cancer

Abstract

Pelvic recurrence is a common outcome following resection with curative intent for rectal cancer originating from various segments of the rectum. In this retrospective observational study involving 219 patients, surgical treatments were administered between 2014 and 2019 across three surgical centers. Procedures included anterior resection with Hartmann’s method (39 patients), anterior resection of rectosigmoid with colorectal anastomosis (130 cases), and abdominoperineal resection (44 cases). After a 2-year follow-up, pelvic recurrence occurred in 19 patients, constituting approximately 8.9% of cases. Recurrent rates were 15.38% for the Hartmann procedure, 9% for abdominoperineal resection, and 7% for anterior resection of rectosigmoid with colorectal anastomosis. The recurrence rate (RR) significantly correlated with the diagnostic stage: stage IV had a 31.4% RR, stage III had a 42.4% RR, stage II had a 21% RR, and stage I had a 5.2% RR. The survival rate among surgically treated patients was 91.99% in the first 2 years after treatment. The findings suggest that rectal cancer diagnosed in advanced stages carries a higher recurrence risk, while a lower recurrence rate indicates the success of curative surgical treatment. Notably, the Hartmann procedure, often performed as an emergency operation for locally advanced lesions, demonstrated the highest recurrence rate.