Fujita S et al. - In a trial to investigate the outcome of pts who underwent curative surgery without adjuvant radiotherapy to clarify indications for preoperative adjuvant radiotherapy for rectal cancer, it was found that patients with rectal cancer located less than 5 cm from the anal verge and with clinically positive lymph nodes should be given preoperative adjuvant radiotherapy Methods
817 consecutive pts who underwent curative surgery for clinical stage II or III rectal cancer without preoperative adjuvant radiotherapy were reviewed
Results
The actuarial 5-year local recurrence rate in examined pts was 6.2%
Univariate analysis showed that sex, pathological T classification (pT), clinical N classification (cN), pathological N classification (pN), tumor site, distance from the anal verge, type of surgery, pathological stage, a positive radical margin, lymphatic invasion, and venous invasion were significantly correlated with local recurrence
Multivariate analysis of preoperative factors identified cN, distance from the anal verge, and sex as statistically significant risk factors for local recurrence
In pts with rectal cancer located less than 5 cm from the anal verge and with positive cN, the local recurrence rate was more than 10%
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