1993 Volume 53 Issue 4 Pages 349-353
Between 1980 and 1989, 112 patients had curative resection for solitary carcinoma of the rectum. Of these 112 patients, 12 (10.6 %) who developed local recurrence were clinicopathologically studied. The average interval from operation to recurrence was one year and 11 months, and there was recurrence within 3 years in 83.3 %, The risk of local recurrence increased in cancers of the lower rectum (Rb), tumor diameter of 4.1 cm or larger, type 3 (infiltrating and ulcerating type), invasion depth of a2 (s) -ai (si), and lymph node metastasis, including carcinoma infiltration (ew) of not more than 4 mm at the external surgical surface. Local recurrence rate increased with increase in positive lymph node metastasis. There was recurrence in 9 out of 63 cases (14.3 %) after Miles' operation, and in 3 out of 33 (9.1 %) after anterior resection. This difference was not significant. There was a trend toward decreased survival of patients who developed local recurrence. In operating on rectal cancers, the importance of appropriate lymph node dissection and excision of the carcinoma with sufficient surrounding tissue should be emphasized.
