Abstract
Background
Mobilization of rectal cancer can be difficult if the tumour is located anteriorly and may result in a higher incidence of local recurrence. The aim of this study was to determine whether local recurrence and survival following curative resection of rectal cancer were associated with the position of the tumour.
Methods
Data were drawn from a comprehensive, prospective hospital registry of all resections for rectal cancer from January 1990 to December 1998, with follow-up to December 2003.
Results
The 5-year local recurrence rate was 15ยท9 (95 per cent confidence interval (c.i.) 11ยท0 to 22ยท8) per cent in 176 patients with tumours that had an anterior component compared with 5ยท8 (95 per cent c.i. 2ยท8 to 11ยท9) per cent in 132 patients with tumours without an anterior component (P = 0ยท009). This association persisted after adjustment for other factors linked to local recurrence (hazard ratio (HR) 2ยท4 (95 per cent c.i. 1ยท1 to 5ยท4)). Similarly, anterior position had a significant negative independent association with survival (HR 1ยท4 (95 per cent c.i. 1ยท0 to 2ยท00)).
Conclusion
Anterior position is an independent negative prognostic factor for both local recurrence and survival after curative resection of rectal cancer.