Local recurrence of restal cancer (LR) after 'curative' surgery is a major clinical problem, with an incidence of 10-30%, a low resectability rate and a dismal prognosis. Prediction of LR might permit more targeted and appropriately scheduled post-operative surveillance of patients with earlier diagnosis of recurrent disease and might help selecting the patients to be assigned to the most suitable adjuvant treatment protocol. To evaluate if a simple multivariate model could predict the LR and survival probability in the single case, we retrospectively evaluated 118 consecutive patients (63M, 55F; mean age 62 ± 12 years) operated on for rectal cancer and followed-up for a mean of 39.8 ± 32.5 months (2-78). Local recurrence occurred in 32 patients (28%), with 7 cases (6%) having local + distant failure. Age and sex of patients, type of surgery, location of tumour in the rectum, size, morphology and grading of the tumour were all unrelated to the event under investigation, At Cox regression, the Dukes' stage and the postoperative radiotherapy were the only independent prognostic factors for LR (p <0.001). Similarly, survival was influenced only by the Dukes' stage, the presence of hepatic metastases at the initial operation and local recurrence. The multivariate model was able to correctly reclassify the patients and predict local recurrence in 86.2% of the cases. Predictive accuracy for survival was 90%. Prevention of LR by adequate surgery and adjuvant therapy as well as its early detection offer the best prospect of improving the results of surgery for rectal cancer.
|Translated title of the contribution||Previsional model of local recurrence and survival after major surgery for rectal cancer|
|Number of pages||9|
|Publication status||Published - 1996|
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