Outcome of Anterior Resection for Stage II Rectal Cancer Without Radiation: The Role of Adjuvant Chemotherapy

The median age of the patients was 69 (range, 27–89) years and the median level of the tumor from the anal verge was 8 (range, 3–20) cm. Four patients (1.8 percent) died in the postoperative period and postoperative complications occurred in 74 patients (33 percent). The median follow-up time of the surviving patients was 43.6 months. The actuarial five-year recurrence rate was 25.4 percent, whereas the five-year actuarial local and systemic recurrence rates were 6.1 percent and 20 percent, respectively. On multivariate analysis, independent factors associated with a higher recurrence rate included lymphovascular invasion, perineural invasion, and absence of chemotherapy. The overall and cancer-specific survival rates of the patients were 71.1 percent and 81.1 percent, respectively. On multivariate analysis, only adjuvant chemotherapy (<ITALIC>P</ITALIC> = 0.024; hazard ratio = 6.04; 95 percent confidence interval, 1.27–28.74) and the absence of lymphovascular invasion (P = 0.002; hazard ratio = 3.77; 95 percent confidence interval, 1.63–8.77) were independent factors associated with significantly better cancer-specific survival.