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Local recurrence of rectal cancer in patients not receiving neoadjuvant therapy – the importance of resection margins

Authors:

BK Dassanayake,

Department of Surgery, University of Kelaniya, LK
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S Samita,

Board of Study of Biostatistics, Postgraduate Institute of Agriculture, University of Peradeniya, LK
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RYI Deen,

Department of Surgery, University of Kelaniya, LK
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NSA Wickramasinghe,

Department of Surgery, University of Kelaniya, LK
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J Hewavisenthi,

Department of Pathology, University of Kelaniya, LK
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KI Deen

Department of Surgery, University of Kelaniya, LK
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Abstract

Objectives Local recurrence of rectal cancer reduces quality of life and survival. A multi-factorial linear logistic model was used to analyse risk factors for local recurrence in rectal cancer in patients not receiving preoperative chemo-radiation.

Methods A case-control study of patients with rectal cancer having surgery with curative intent, between 1996 and 2008. Eighteen putative risk factors for local recurrence were subjected to uni-variate analysis. Significant factors were selected for multi-factorial analysis.

Results Twenty-one patients with local recurrence (cases) and 78 controls were selected. Uni-variate analysis showed significant associations with recurrence for nodal stage (N) (p=0.027), metastasis (M) (p=0.009), adjuvant chemotherapy (p=0.039), positive resection margin (R) (p=0.018) and American Joint Committee for Cancer (AJCC) tumours above stage II (p=0.043). Significant uni-variate odds ratios (OR) were obtained for the same factors. Two linear logistic models were fitted as (1) N, M, R1 status and adjuvant chemotherapy and (2) AJCC stage, R1 status and adjuvant chemotherapy. From both models, the only factor significantly associated (p≤0.01) with local recurrence was found to be a positive resection margin (OR 4.81 and 5.51 respectively).

Conclusions A positive resection margin is the single factor affecting local recurrence of rectal cancer in patients not receiving neo-adjuvant therapy.

(Index words: rectal cancer; local recurrence; linear logistic models)

DOI: http://dx.doi.org/10.4038/cmj.v56i4.3896  

Ceylon Medical Journal 2011; 56: 159-161

DOI: https://doi.org/10.4038/cmj.v56i4.3896
How to Cite: Dassanayake, B., Samita, S., Deen, R., Wickramasinghe, N., Hewavisenthi, J. and Deen, K., 2011. Local recurrence of rectal cancer in patients not receiving neoadjuvant therapy – the importance of resection margins. Ceylon Medical Journal, 56(4), pp.159–161. DOI: http://doi.org/10.4038/cmj.v56i4.3896
Published on 30 Dec 2011.
Peer Reviewed

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