RATE AND TREATMENT OF PELVIC RECURRENCE AFTER ABDOMINOPERINEAL RESECTION AND LOW ANTERIOR RESECTION FOR RECTAL-CANCER

PURPOSE: This study was designed to analyze factors of importance for local recurrence after radical surgery for rectal cancer and to analyz e course and outcome of treatment of pelvic recurrence. METHODS: One h undred seventy-five patients treated for rectal cancer with low anteri or resection (LAR) or abdominoperineal resection (APR) were studied, r etrospectively. Seventy-four patients had LAR and 101 had APR. RESULTS : The two groups were comparable with respect to Dukes classification, histologic differentiation, and male to female ratio. The rate of pel vic recurrence was 18 percent for LAR and 24 percent for APR (not sign ificant). Recurrence rates were 27 percent after stapled anastomoses a nd 10 percent after handsewn anastomoses respectively (P = 0.09). Twen ty five had pelvic recurrence diagnosed without signs of distant metas tatic disease. They were treated with radiotherapy, palliative operati ons, or analgesics. The group receiving radiotherapy had a significant ly longer survival (15.9 months) compared with other groups (2.4 month s; P < 0.001). CONCLUSIONS: There is no difference in local recurrence rate after LAR and APR. Radiotherapy seems to increase survival in pa tients with an unresectable recurrence and should be offered irrespect ive of pain.