Patterns of recurrence in adenocarcinoma of the rectum and rectosigmoid treated with surgery alone: implications in treatment planning with adjuvant radiation therapy.

This is an analysis of 140 patients with adenocarcinoma of the rectum and rectosigmoid treated with surgery alone at the University of Florida between May 1959 and April 1976. Patients in the study group had a complete resection, as determined by the surgeon and the pathologist, and no evidence of distant metastasis at the completion of the operation. There is a 5 year minimum follow-up. Local-regional recurrence rates were noted to vary with histologic grade, length of the lesion, and pathologic stage. Approximately 60% of local-regional and distant recurrences were noted by 2 years after treatment, and 92-95% were noted by 5 years. Evaluation of patient status at 5 years revealed that 0% (Stage CIS), 0% (A), 17% (B1), 13% (B2), 17% (C1), and 28% (C2) had developed local-regional recurrence without demonstrable distant metastasis. Complications and crude 5 year survival rates are presented and current treatment modifications discussed.