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  • Title: The nature of local recurrence after colorectal cancer resection.
    Author: Thomson WH, Foy CJ, Longman RJ.
    Journal: Colorectal Dis; 2008 Jan; 10(1):69-74. PubMed ID: 17509052.
    Abstract:
    OBJECTIVE: Local recurrence (LR) after rectal cancer resection has long been regarded as a particular problem, its incidence having been high. This study aims to determine the reasons why. METHOD: A prospective record was kept of all 887 cases of colorectal adenocarcinoma referred to one surgeon between 1989 and 2000. Of these, 802 underwent major resection. They were followed up for 5 years or until death. RESULTS: There was no significant difference between LR rates throughout the colorectum (P = 0.74). LR was significantly related to tumour grade (P < 0.001) and to tumour stage (P < 0.001), but not to the need to resect involved adjacent structures (P = 0.08), nor, after restorative rectal resection, to the distal margin of clearance (P = 0.97). A difference became apparent between recurrence resulting from tumour left in or implanted into the operation field and tumour resulting from pre-excision metastasis, here called, respectively, technique-related (TLR) and pre-excision metastatic (MLR) local recurrence. MLR was significantly related to tumour stage (P < 0.001), while TLR was not. Some TLR can be curatively excised. CONCLUSION: Rectal LR is no more common than colonic LR. There may be practical merit in discriminating between TLR and MLR.
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