Predictors of recurrence after surgery in patients with localized rectal tumors

This study looked at survival and recurrence rates among patients with localized rectal cancer (one that has not spread beyond the rectum). The researchers tried to identify patients at a higher risk that might benefit from more aggressive treatment.

Node negative (or N0) rectal cancer is a cancer that has not yet spread to nearby lymph nodes. These cancers are usually treated with radiotherapy and excised with surgery (a procedure called radical total mesorectal excision or TME). However, recurrence of the cancer is a concern, and more aggressive treatment with chemotherapy might be considered. This study attempted to identify which patients are at the highest risk for recurrence and might benefit from more aggressive treatment.

Carcinoembryonic antigen (CEA), a molecule found in the bloodstream of patients with rectal and colon cancer, is often used to monitor the progression of the disease.

This study followed 94 patients with N0 rectal cancer that were treated with surgery (TME) alone. After 5 years 8% of the patients experienced a recurrence of the cancer. At 8 years the recurrence rate was 10%. The study showed that lymphovascular invasion, or LVI (microscopic evidence that cancer cells have invaded blood or lymph vessels) increases the risk for cancer recurrence. CEA levels before surgery of 5 or above, and age over 70 were also associated with worse survival and increased recurrence rates.

LVI, preoperative CEA levels and old age indicate a high risk in N0 rectal cancer patients. High risk patients might benefit from a more aggressive treatment plan.

This study is limited by the relatively small number of patients it included.

Consult with your physician regarding the risk of cancer recurrence and the best treatment plan suited for you.