LOCAL RECURRENCE FOLLOWING CURATIVE SURGE RY FOR CANCER OF THE RECTUM

Using the Registre des Tumeurs Digestives of the Cote-d'Or, a survey w as conducted to study the risk of local recurrence of patients after c urative surgery for rectum cancer diagnosed between 1976 and 1984 in t he above mentioned department. Data was available in May 1987 for 448 patients, or 95% of the recorded cases. The cumulative local recurrenc e rate was 5.9% at 1 year, 19.1% at 3 years and 24.4% at 5 years. It w as independent of sex, age, site of the cancer, time of diagnosis and length of distal margin (for cancers treated by anterior resection). O n the other hand, the risk of local recurrence varied with macroscopic appearance (distinguishing fungating cancers from other macroscopic t ypes), size (less than 6 cm on more than 6 cm), extension into the bow el wall (cancer limited or not to the wall) and degree of node invasio n (no node involvement, 1 or 2 invaded nodes, more than 2 invaded node s). The results of Cox model indicate that these 4 variables independe ntly influence the risk of local recurrence. These data, which are int eresting because of having been collected from a general population, a re useful in planning therapeutic trials and in specifying postoperati ve surveillance methods. They suggest that, independently of extension into the bowel wall and node involvement, the macroscopic appearance and size of the cancer influence the risk of local recurrence.