Local recurrence in adenocarcinoma of the rectosigmoid colon after curative surgical resection.

Between January 1975 and January 1982, 157 patients with a diagnosis of adenocarcinoma of the rectosigmoid colon underwent curative surgical resection. The median follow-up was three years (range, 2.5 to 9 years). Two patients were excluded from the study for staging purposes because they received preoperative radiation. The remaining patients were categorized in the following stages: carcinoma in situ-3; A-14; B(1)-14; B(2)-41; B(3)-8; C(1)-1; C(2)-70; and C(3)-4. The overall local recurrence rate was 41 percent. The local recurrence according to stage was as follows: stage A-1/14 (7 percent); B(1)-2/14 (14 percent); B(2)-15/38 (39 percent); B(3)-3/8 (38 percent); C(1)-0/1; C(2)-31/56 (55 percent); and C(3)-4/4 (100 percent). Seventeen patients in stages B(2) and C(2) received postoperative irradiation. Only two patients (2/17, or 12 percent) recurred locally. In this study the local recurrence rate for patients undergoing curative surgical resection only was very high, especially in patients with advanced stage of disease (B(2) to C(3)). There is evidence that postoperative radiotherapy could minimize the local failure rate.