PROGNOSTIC FACTORS OF LOCAL RECURRENCE AF TER OPERATIVE TREATMENT OF RECTUM CARCINOMA

From January 01, 1985 to December 31, 1993 515 patients with primary r ectal cancer underwent operative treatment at the hospital of general and abdominal surgery of the university of Mainz. In 294 patients with conventional surgical treatment and RO-resection of the tumor we inve stigated the influence of tumor-, patient- and therapeutic factors on local tumor recurrence. At a univariate analysis the following factors were significant: UICC-staging (p=0,001), pT-classification (p=0,001) , pN-classification (p=0,013) and localisation of the tumor (p=0,013). These results could be verified for the pT-classification and pN-clas sification in a multivariate analysis. The significant influence of op erative treatment (p=0,034), blood transfusion (p=0,018) and preoperat ive raised CEA (p=0,026) depended on significant differences of UICC - staging and tumor - localisation of the different groups. Grading, se x and age had no influence. Inspite of a shift of local resurrence fro m 13% to 50% (0% to 42,9% for resections, respectively 6,7% to 55,4% f or exstirpations) we could not find a significant influence of the sur geon. This fact depended on the dividing of a small number of cases on a lot of surgeons. In our opinion the influence of the surgeon or of different hospitals on local recurrence should he investigated in furt her studies.