LOCAL RECURRENCE AND SURVIVAL IN PATIENTS WITH RECTAL-CANCER, DIAGNOSED 1981-86 - A COMMUNITY HOSPITAL-BASED STUDY IN THE SOUTH-EAST NETHERLANDS

We carried out a population-based audit of local recurrence rates in c uratively resected patients with rectal cancer, diagnosed between 1981 and 1986. The study comprises 372 patients treated for rectal cancer in five community hospitals in the south-east of the Netherlands. The follow-up period was 7-12 years. We studied the medical records of the se patients in the Eindhoven Cancer Registry, and by checking the endo scopical, surgical and pathological reports, we traced the following e vents: local recurrence, distant metastasis and (cause of) death, Cura tive resection was carried out in 232 of the 372 cases (62%); post-ope rative radiotherapy was administered to 27% of stage B2 and 50% of sta ge C (Astler-Coller) patients. Crude and net 5-year survival rates wer e 45% and 58%, respectively. Local recurrence rates were 18%, without much variation per hospital. After adjustment for age, gender, tumour site and type of surgery, local recurrence was primarily determined by tumour penetration of the muscularis propria and lymph node infiltrat ion, the relative risks being 2.5 and 3.1, respectively (90% confidenc e intervals: 1.1-5.9 and 1.5-6.4). Although patients with cancer of th e distal segment (0-6 cm) had shorter survival times than with proxima l tumours, tumour site only weakly influenced local recurrence rates. These results confirm that the risk of recurrence for stage B2 and C p atients can he reduced by more extensive surgical procedures. This stu dy has contributed to the growing awareness of improved surgical treat ment in rectal cancer.