Risk factors influencing local recurrence in the laparoscopic curative treatment of rectal cancer: aprospective analysis in 453 consecutive patients: P083


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Abstract

Aim:The aim of our study is to identify and to analyze the risk factors of local recurrence in the laparoscopic curative treatment of Rectal Cancer.Method:Prospective observational study of 453 consecutive patients submitted to laparoscopic curative surgery of rectal cancer since January 1998 to December 2009. For the differences in local recurrence we analyzed the data with log-rank test and Cox regression.Results:The median follow-up time was 45.39 months (IQR 17.0-67.8). The local recurrence was 6.8%. The median time of local recurrence was 24 months (IQR 8.3-33.6). The conversion was 9.9% and not associated with high local recurrence (P = 0.14). In the multivariate analysis the risk factors associated with local recurrence were: distal tumors (P = 0.01), N2 stage (P < 0.001), advanced TNM stage (P = 0.023), first period of our learning curve (P = 0.009) and surgeons with < 50 cases of experience (P = 0.021). There was a non-significant decrease in local recurrence rate in patients treated by neo-adjuvant therapy either in total mesorectal excision surgery and residual status.Conclusion:The local recurrence in our series of laparoscopic surgical treatment for rectal cancer depends on advanced TNM stage particular in N2, distal localization and the experience of the surgeon. The results are similar to the published data of conventional surgery.

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