Local recurrence is one of the remaining problems in rectal and rectosigmoid cancer, and it is sometimes difficult to treat.
Dr Koya Hida and colleagues explored various factors that are highly related to local recurrence, and developed a new prediction model for local recurrence after curative resection.
The team performed a retrospective cohort study at 2 academic hospitals in Japan and Korea.
The research team selected a total of 2237 patients with stage I to III rectal and rectosigmoid cancer who underwent a curative operation with a negative circumferential margin.
Surgical treatment was the intervention and the team's primary outcome measure was local recurrence.
|Patients who scored more than 5 points had a 2-year local recurrence rate of 67%|
|Diseases of the Colon & Rectum|
A total of 1232 patients were selected, and rectosigmoid cancer with rare local recurrence was excluded.
A different set of 792 patients with rectal cancer were chosen for validation.
The researchers showed the following factors as significant for local recurrence: poorly differentiated tumor, tumor depth, lymph node metastasis, operative procedure, postoperative complications, tumor location, and CEA level.
The team created a new prediction score was created by using these factors.
A poorly differentiated tumor was assigned 2 points, and all other factors were assigned 1 point each.
Patients who scored more than 5 points were judged as 'high risk', with a 2-year local recurrence rate of 67%.
The new predictive model could also separate the patients into different risk groups in the validation set.
The researchers noted that high-risk group had higher recurrence rates than medium- and low-risk groups.
Dr Hida's team concludes, "Seven factors were shown to be significantly correlated with the local recurrence of rectal cancer, and the usefulness of this new prediction model was demonstrated."