Local recurrence after curative resection of rectal cancer: A comparison of low anterior resection and abdominoperineal resection

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Abstract
Local recurrence rates after either low anterior resection or abdominoperineal resection were compared in 109 patients undergoing curative surgery for adenocarcinoma of the rectum between 1979 and 1984. Follow-up information was available for 99 patients (91%). The overall recurrence rate was 19%; ten recurrences (26.3%) for low anterior resections and nine (14.7%) for abdominoperineal resections. (P < .08). Recurrences were confirmed by biopsy or at reoperation. No significant difference in size of the lesion was evident at initial resection (average largest dimension 4.8 cm for low anterior and 5.5 cm for abdominoperineal resection). The average time to recurrence after resection was 18 months (16.5 months in the low anterior group vs. 19 months in the abdominoperineal group). Mean survival after recurrence was shorter for the abdominoperineal (3.4 months) as compared to the low anterior group (9.5 months) (P = .10). The overall median survival was 21 months (range 0–75 months) in both groups, and 38 patients were alive. Risk factors for recurrence were Dukes C lesions in patients who had a low anterior resection (8/18 or 44% recurrence) and poor histologic differentiation in patients who had either operation (3/6 or 50% recurrence).