Local recurrence after curative resection for rectal cancer – role of the multi – disciplinary team

Objective:  We believe optimal management of rectal cancer should be tailored to the individual patient. This is achieved by close liaison within a well-established multidisciplinary team (MDT). Patients also benefit from the unusual alliance between our district general hospital and regional oncology center with expertise in radiotherapy for rectal cancer. To test our beliefs, we reviewed the incidence of local recurrence following curative resection for rectal cancer. Method:  A total of 201 consecutive patients with rectal cancer treated from 1 April 1999 to 31 March 2002 were reviewed by one author (GK). 100 per cent case note retrieval was achieved of which 122 curative resections were identified (122/201 = 60.7%). Mean follow-up 4½ years. Conclusion:  The incidence of local recurrence was 2.5% (3/122). All occurred in patients having Hartmann's operation. There were no local recurrences following anterior resection or abdomino-perineal resection. Discussion:  Data support our belief that, combining modern surgical techniques with radiotherapy ± chemotherapy, high quality outcomes are achievable when care is tailored to individuals by a functional MDT.   Number (%) Average distance from anal verge (cm) Number (%) receiving preoperative radiotherapy Anterior resection 76/122 (62.3) 11.2 13/76 (17.3) Hartmanns 9/122 (7.4) 8 4/9 (44.4) Abdomino-perineal resection 27/122 (22.1) 4.7 11/27 (40.7)