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Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum: Clinicopathologic correlation and implications for adjuvant therapy
Author(s) -
Gunderson Leonard L.,
Sosin Henry
Publication year - 1974
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197410)34:4<1278::aid-cncr2820340440>3.0.co;2-f
Subject(s) - medicine , rectum , adjuvant therapy , surgery , lymph node , adenocarcinoma , lymph , adjuvant , metastasis , distant metastasis , disease , cancer , chemotherapy , pathology
Seventy‐five patients with complete bowel wall penetration and/or positive lymph nodes at the time of initial “curative surgery” had planned single or multiple reoperations at the University of Minnesota. Tumor due to rectal carcinoma was found in 52. Four were converted to disease‐free status. Areas of failure were analyzed in detail. Distant metastasis (DM) alone was uncommon. Peritoneal seeding (PS) was rare. Local failure and/or regional lymph node metastases (LF‐RF) occurred as the only failure in nearly 50% of the failure group and as some component in 92%. Patterns of failure are fairly predictable if anatomical factors and initial pathologic extent of tumor are considered. Postoperative irradiation may be a logical adjuvant in view of the high percentage of local‐regional failures and the ability to identify subgroups of patients at highest risk for such failure.