Mortality, morbidity, and patterns of recurrence after abdominoperineal resection for cancer of the rectum.

Records of 230 patients who underwent abdominoperineal resection between 1963 and 1976 were reviewed. The median age of the patients was 62 years. The mortality rate was 1.7 per cent, and the morbidity rate was 61 per cent. One hundred eighty patients were followed for five to 13 years to identify patterns of recurrence. Ten-year survival for Dukes' A, B, and C lesions was 83 per cent, 57 per cent, and 31 per cent, respectively. Seventy-eight patients (43 per cent) had recurrent cancer; 10 per cent had local lesions, and 33 per cent had distant lesions. Dukes' B lesions had a greater latency for local recurrence than Dukes' C lesions. Dukes' A lesions with distant recurrence had a greater latency than Dukes' B or C lesions. Once recurrence was established, the survival rate was not significantly different, regardless of Dukes' stage or local or distant site. Radiation therapy for established local recurrence or chemotherapy for established distant recurrence did not seem to alter survival rates.