PubMedDate not supplied
OBJECTIVE: Our institution's experience with low anterior resection for primary rectal cancer was reviewed to determine cancer treatment results and to identify risk factors for pelvic recurrence. METHODS: Ninety-two patients treated for primary rectal cancer between 1986 and 1997 were studied retrospectively. All cases was classified according to Astler-Coller. Median follow up was 46 months. RESULTS: Actuarial 5-year survival for all patients was 79%. Among 28 patients who relapsed, only 9 pelvic recurrence was detected with an actuarial rate of 15% at 5 years. Lymph nodes involvement were associated with increased risk for pelvic recurrence. DISCUSSION: Low anterior resection permitted by circular stapler provides good treatment for mid-rectal cancers and for some distal rectal cancers. Pelvic recurrence is not correlated with neoplasm localization, T stage and short distal resection margins, but only with the presence of lymph nodes involvement. This result increase the value of the hypothesis that search the pelvic recurrence origin in a extra-parietal disease respect anastomotic disease. CONCLUSION: Fundamental to prevent pelvic recurrence is the surgical technique that have to remove lymph node en bloc with the rectum doing a dissection along the endopelvic fascia to Denonvillers fascia so to take away completely the mesorectum.