Survival and locations of recurrence following abdomino-perineal resection for rectal cancer

Records of 134 patients treated by abdomino-perineal resection (1971-1979) were reviewed. One hundred and thirteen had curative operations. Mortality was 2.6% and morbidity was 51%. Ninety-three were evaluable and were followed for 5 to 8 years; they were evaluated for survival and pattern of recurrence. Five-year survival for Dukes' A, B, C, and D lesions was 86, 62, 31, and 0%, respectively. Thirty-seven had recurrence: Four pelvic, nine pelvic and distant, and 24 only distant lesions. The overall incidence of failures was 47%, failure rates by stage were 11% for stage A, 27% for B, 48% for C, and 70% for D. Incidence of local recurrence was significantly higher in stage C compared to stage B. Irrespective of stage, after detection of local or distant recurrence, survival did not differ. Furthermore, radiotherapy for local recurrence and chemotherapy for distant lesions did not improve survival time.