Quantitative Assessment of Prognosticators for Rectal Cancer’s Local Recurrence and Distant Metastases

Abstract

Rectal cancer treatment outcome has improved considerably in the TME era often with the use neoadjuvant chemoradiotherapy. However, the risk of local recurrence/distant metastases could be as high as 10%. We have designed a retrospective cohort study to assess risk factors associated with local recurrence/distant metastasis after primary curative rectal resection. Our analysis of the colorectal database in a district general hospital involved review of 131 patients who had a curative resection between 2007 and 2013. 22 patients of the 131 had local recurrence/distant metastases. We reviewed the risk factors as gender, neoadjuvant chemoradiotherapy, type of operation, anastomotic leak, tumour differentiation, EMVI, CRM and Dukes C and performed a quantitative assessment. Looking at risk factors, the presence of EMVI was found to have a statistically significant association with recurrence and distant metastases (p=0.0006) followed by poor differentiation (p= 0.038) and Dukes C (p=0.045) while CRM involvement (p=0.054), Neoadjuvant chemoradiotherapy (p=0.657), type of resection (p=0.740), Anastomotic leak (p=0.761) and gender (p=0.901) shown no obvious statistical association with recurrence or distant metastases A larger multi-centre study may help in validating our observation.