Retreatment For Postoperative Local Recurrence Of Rectal Carcinoma

Objective To discuss the causes and treatment of local recurrence in patients after operation for rectal carcinoma.Methods From Jan.1993to Jan.2001,Compare 115 cases of local recurrent rectal cancer with 70 cases no-recurrent rectal cancer;93 cases of local recurrent rectal cancer were retreated,32 cases were treated by resection combined with radiotherapy(groupⅠ),34 were underwent resection(groupⅡ)and 27 patients received radiotherapy alone(groupⅢ),The other 22 patients were untreated.Results Recurrence rate of male is higher than female(χ~2=4.53,P＜0.05);41 cases were moderately and well differentiated,74 cases were poorly differentiated,there were statistically significant between them in recurrence rate,(χ~2=15.78,P＜0.01);Duckes A 2 cases,Duckes B 44 cases,Duckes C 69 cases, Duckes A and Duckes B were higher Duches C in recurrence rate(χ~2=6.787vs22.281,P＜0.01);76 cases tumours located 4-6cm from anal verge,39 cases tumours located exceed than 6cm from the anal verge,there were statistically significant between them in recurrence rate(χ~2=26.41,P＜0.01).In recurrent group,there were 103 cases whose CEA were higher than nomal,there were not statistically significant between groupⅠand groupⅡin change of CEA after different treated;there were statistically significant between groupⅠ,groupⅡand groupⅢ,groupⅣ;there were not statistically significant between groupⅢand groupⅣ.The median survival times of groupⅠ,Ⅱ,Ⅲand untreated group were 28,24,11and 4 months respectively.The survival rates of groupⅠandⅡwere better than of groupⅢsignificantly(P＜0.05).Conclusion Recurrence rate of local recurrent rectal carcinoma was leated to gender,Dukes stage,patho-category,tumour local from the anal verge;The local recurrence of rectal carcinoma still need actively surgical treatment in order to prolong the survival time.