Factors predicting recurrence after curative resection for rectal cancer: a 16-year study

Waad Farhat, Mohamed Azzaza, Abdelkader Mizouni, Houssem Ammar, Mahdi Ben Ltaifa, Sami Lagha, Mohamed Kahloul, Rahul Gupta, Mohamed Ben Mabrouk, Ali Ben Ali, Waad Farhat, Mohamed Azzaza, Abdelkader Mizouni, Houssem Ammar, Mahdi Ben Ltaifa, Sami Lagha, Mohamed Kahloul, Rahul Gupta, Mohamed Ben Mabrouk, Ali Ben Ali

Abstract

Background: The recurrence after curative surgery of the rectal adenocarcinoma is a serious complication, considered as a failure of the therapeutic strategy. The aim of this study was to identify the different prognostic factors affecting the recurrence of adenocarcinoma of the rectum.

Methods: A retrospective analysis of patients operated for adenocarcinoma of the rectum between January 2000 and December 2015 was conducted. The study of the recurrence rate and prognostic factors was performed through the Kaplan Meier survival curve and the Cox regression analysis.

Results: During the study period, 188 patients underwent curative surgery for rectal adenocarcinoma, among which 53 had a recurrence. The recurrence rate was 44.6% at 5 years. The multivariate analysis identified four parameters independently associated with the risk of recurrence after curative surgery: a distal margin ≤ 2 cm (HR = 6.8, 95% CI 2.7-16.6, 6), extracapsular invasion of lymph node metastasis (HR = 4.4, 95% CI 1.3-14), tumor stenosis (HR = 4.3, 95% CI 1.2-15.2), and parietal invasion (pT3/T4 disease) (HR = 3, 95% CI 1.1-9.4).

Conclusion: The determination of the prognostic factors affecting the recurrence of rectal adenocarcinoma after curative surgery allows us to define the high-risk patients for recurrence.

Trial registration: ClinicalTrials.gov Identifier: NCT03899870 . Registered on 2 February 2019, retrospectively registered.

Keywords: Prognosis; Rectal adenocarcinoma; Recurrence.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
predicting recurrence rate in function of time after curative resection for rectal adenocarcinoma
Fig. 2
Fig. 2
Kaplan-Meier curves comparing the recurrence-free survival of the patients according to the four parameters independently associated with the risk of recurrence after curative surgery. a Distal margin (log-rank = < 10− 3). b Extracapsular invasion of lymph node metastasis (log-rank = 0.015). c Tumor stenosis (log-rank = 0.016). d Parietal invasion according to the TNM classification (log-rank = 0.016)

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