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Factors associated with the location of local rectal cancer recurrence and predictors of survival

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The location of locally recurrent rectal cancer (LRRC) may influence survival. This study examines factors affecting the location of LRRC, the effect of LRRC location on survival, and predictive factors for survival in patients with LRRC.

Methods

Patients undergoing initial proctectomy and subsequent management of LRRC at the Cleveland Clinic (1980–2011) were included. Data regarding index surgery, LRRC, and survival were obtained from a prospectively maintained database.

Results

One hundred and fifty-seven patients were identified with a mean follow-up 59.8 ± 50.1 months and time to LRRC of 31.7 ± 30.1 months. Sixty patients underwent surgery with curative intent. Anastomotic leak and retrieving less than 12 lymph nodes at index proctectomy were associated with posterior (P = 0.019) and lateral (P = 0.036) recurrences, respectively. Having an axial relative to an anterior, posterior, or lateral recurrence was associated with improved overall survival (P = 0.001). On multivariable analysis, undergoing primarily palliative treatment (OR, 5.2; 95 % confidence interval (CI), 3.2–8.4; P < 0.001), age at LRRC >60 years (OR, 1.9; 95 % CI, 1.3–2.7, P < 0.001), advanced primary tumour stage (OR, 1.5; 95 % CI, 1.1–2.1; P = 0.021), and anastomotic leak at index surgery (OR, 1.8; 95 % CI, 1.2–2.7; P = 0.008) were associated with reduced LRRC 5-year survival.

Conclusions

The current study suggests that features of the primary tumour and technical factors at the time of index proctectomy influence both the location of LRRC and survival.

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Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, A30, Cleveland, OH, 44195, USA

    Peng Du, John P. Burke, Wisam Khoury, Ian C. Lavery, Ravi P. Kiran, Feza H. Remzi & David W. Dietz

Authors
  1. Peng Du
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  2. John P. Burke
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  3. Wisam Khoury
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  4. Ian C. Lavery
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  5. Ravi P. Kiran
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  6. Feza H. Remzi
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  7. David W. Dietz
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Corresponding author

Correspondence to David W. Dietz.

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The authors declare that they have no competing interests.

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Du, P., Burke, J.P., Khoury, W. et al. Factors associated with the location of local rectal cancer recurrence and predictors of survival. Int J Colorectal Dis 31, 825–832 (2016). https://doi.org/10.1007/s00384-016-2526-5

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  • DOI: https://doi.org/10.1007/s00384-016-2526-5

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