Time pattern and prognostic evaluation of the recurrence of rectal cancer after resection

Objective To investigate the regular pattern and prognostic evaluation of patients with recurrent rectal cancer after resection. Methods Three hundred and fourteen cases with recurrent rectal cancer after resection treated between May 1979 and November 2006 were classified into three groups according to the recurrence intervals ( <3 years, 3-5 years, 5 years). The survival rates and prognosis in the three groups were analyzed and compared retrospectively. Results Of the 314 patients, the cancer relapsed in 247 cases (78.7%) in less than 3 years, and the recurrence occurred predominantly within 2 years(207 cases, 65.9% ) after the operation. The neoplasm in 41 cases (13.3%) recurred in 3-5 years after the operation, and 26 cases (8.3%) in more than 5 years after the resection. Disease-free interval, Dukes stage, neoplasm gross type, histological type, T stage, lymphatic and distant metastasis were associated with the prognosis on univariate analysis. And disease-free interval and tumor Dukes stage were independent prognostic factors for survival rate on multivariate analysis. Disease-froe interval and progressionflee survival were related positively with survival time. Conclusions The rectal cancer patients should be followed-up intensively for 2 years after the operation and moderately from then on. Disease-free interval and progression-free survival could be taken as the best predictors of long-term cure and prognosis. Key words: Rectal neoplasms; Neoplasm recurrence, local; Prognosis; Survival rate