Rectal resection for cancer in Lower-Normandy. Assessment of practices, loco-regional recurrences and long-term survival. Results of a regional survey (1988-1993).

Objectives and methods. - A retrospective regional study was set up to iden tify the determinants of loco-regional recurrences and those or survival af ter rectal resection for cancer. The studied population was constituted of 505 patients with resectron for carcinoma of the rectum in Lower-Normandy f rom 1988 to 1993. Results. - The actuarial rate of loco-regional recurrence was 17.3 +/- 4 % at 3 years. The only significant predictive factor of survival free of loco -regional recurence was the Dukes' stage. Actuarial survival rate was 52.0 +/- 4% at 5 years, the corresponding relative survival rate being 64.6 +/- 6 %. The only two independent prognostic factors were the sphincter-saving procedure and adjuvant radiotherapy. Commentaries. - The loco-regional recurrence rate after resection for recta l cancer is still high. Sphincter-saving procedure and adjuvant radiotherap y increase over the rime. Since the study was retrospective, no definitive conclusions could be drawn. Nevertheless, they incite Its to set up larger prospective regional studies including quality control of surgical procedur es, radiotherapy protocols and histopathological reports.