Clinicopathological features of anastomotic recurrence after an anterior resection for rectal cancer.

Purpose: Anastomotic recurrence after an anterior resection for rectal cancer has not been analyzed in detail in the era of total mesorectal excision. This study tried to clarify the characteristics of patients with anastomotic recurrence when compared to the pelvic recurrence.

Methods: This study compared the clinicopathological data of 21 isolated recurrent patients that were treated between 1998 and 2007, including eight with anastomotic recurrence and 13 with pelvic recurrence.

Results: The rate of positive serum carcinoembryonic antigen level at the time of recurrence is 0% in the anastomotic recurrence group and 85% in the pelvic recurrence group (p < 0.001). The clinical symptoms presented in 13% in the anastomotic recurrence group, in comparison to 69% in the pelvic recurrence group (p = 0.024). The median time from the initial resection until recurrence was 14 months in the anastomotic recurrence group, whereas it was 12 months in the pelvic recurrence group (p = 0.992). The survival rate of patients with anastomotic recurrence was higher than those with pelvic recurrence (p = 0.005).

Conclusion: A difference was observed in the serum carcinoembryonic antigen, clinical symptom, and survival between patients with anastomotic and pelvic recurrence. Furthermore, according to these results, we should pay attention to these clinical features in the follow-up period.