Predictors of local recurrence of rectal cancer after surgery

This study investigated whether certain markers were associated with local recurrence or survival post-surgery in early stage colorectal cancer patients. This trial determined that certain factors were associated with a higher risk of local recurrence (including male gender and current alcohol use) and surivival times (including age of patient).

25% of rectal cancer patients are diagnosed with Stage 1 disease (the cancer has not spread beyond the intestinal wall). Many of these patients have surgery to remove the tumor, but do not have radiation or chemotherapy. The rate of local recurrence (return of the cancer at the original tumor location) for these patients is 4-16%. Prognostic markers have been identified for recurrence in late stage disease. However no such markers have been identified in patients with early stage disease. 

This study investigated whether certain markers were associated with local recurrence or survival rates post-surgery in early stage rectal cancer patients. The records of 175 patients with stage 1 rectal cancer were examined. All patients had undergone surgery but not chemotherapy or radiation. Local recurrence and overall survival (time from treatment until death from any cause) were measured. 

23 patients (16.8%) experienced local recurrence. The average time to local recurrence was 1.1 years. Males had a 3.3 times greater risk of local recurrence. Current alcohol users had a 3.4 times increased risk of local recurrence. Patients with tumor ulceration (a tumor which has broken through the surface of the skin) had a 4.2 times greater risk. Race, smoking status and family history were not associated with the risk of local recurrence.

Average survival was 12 years. Patients who were over age 65 at diagnosis had a 2.1 times greater risk of mortality. T2 stage patients (patients in whom the cancer had spread into the muscle layer) had a 2.5 times greater risk. Race, family history and smoking status did not affect survival.

The authors suggested that these findings could indicate prognostic markers for local recurrence of early stage rectal cancer. It is suggested that if these findings are confirmed, these markers could indicate which patients require more intensive treatments.

Further studies are required to confirm these findings. 

Consult your doctor if you would like to discuss prognostic tests.