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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2009

Open Access 01-02-2009 | Gastrointestinal Oncology

Patterns of Local Recurrence in Rectal Cancer: A Single-Center Experience

Authors: M. Kusters, C. J. H. van de Velde, R. G. H. Beets-Tan, T. Akasu, S. Fujida, S. Yamamoto, Y. Moriya

Published in: Annals of Surgical Oncology | Issue 2/2009

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Abstract

A cohort of patients operated at the National Cancer Center Hospital in Tokyo for rectal carcinoma, at or below the peritoneal reflection, was reviewed retrospectively. The purpose was to study the risk factors for local relapse and the patterns of local recurrence. Three hundred fifty-one patients operated between 1993 and 2002 for rectal carcinoma, at or below the peritoneal reflection, were analyzed. One hundred forty-five patients, with preoperatively staged T1 or T2 tumors without suspected lymph nodes, underwent total mesorectal excision (TME). Lateral lymph node dissection (LLND) was performed in suspected T3 or T4 disease, or when positive lymph nodes were seen; 73 patients received unilateral LLND and 133 patients received bilateral LLND. Of the 351 patients 6.6% developed local recurrence after 5 years. TME only resulted in 0.8% 5-year local recurrence. In lymph-node-positive patients, 33% of the unilateral LLND group had local relapse, significantly more (p = 0.04) than in the bilateral LLND group with 14% local recurrence. Local recurrence in the lateral, presacral, perineal, and anastomotic subsites was lower in the bilateral LLND group as compared with in the unilateral LLND group. We conclude that, in selected patients, surgery without LLND has a very low local recurrence rate. Bilateral LLND is more effective in reducing the chance of local recurrence than unilateral LLND. Either surgical approach, with or without LLND, requires reliable imaging during work-up.
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Metadata
Title
Patterns of Local Recurrence in Rectal Cancer: A Single-Center Experience
Authors
M. Kusters
C. J. H. van de Velde
R. G. H. Beets-Tan
T. Akasu
S. Fujida
S. Yamamoto
Y. Moriya
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-0223-5

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