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R K S Phillips, Rosemary Hittinger, Lynda Blesovsky, J S Fry, L P Fielding, Local recurrence following ‘curative’ surgery for large bowel cancer: I. The overall picture, British Journal of Surgery, Volume 71, Issue 1, January 1984, Pages 12–16, https://doi.org/10.1002/bjs.1800710104
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Abstract
The Large Bowel Cancer Project is a collaborative prospective study of 4228 patients with a histologically proven adenocarcinoma, of whom 2336 (55 per cent) survived a ‘curative’ resection. Follow-up information is available on 2220 patients (95 per cent). Subsequently, 309 (14 per cent) have developed a local recurrence confirmed by: biopsy (127; 41 per cent), clinical examination (77; 25 per cent), X-ray (15; 5 per cent), a raised CEA (2; 1 per cent), or some other method — e.g. CT scan or a confident unbiopsied laparotomy finding (88; 29 per cent).
Statistically significant factors (χ2 test, P<0·05) associated with local recurrence are:
Dukes' classification: A 4 per cent; B 13 per cent; C 18 per cent
Tumour differentiation: Well 11 per cent; Moderate 14 per cent; Poor 21 per cent
Obstruction: Absent 13 per cent; Present 21 per cent
Perforation: Absent 13 per cent; Present 28 per cent
Tumour mobility: Freely mobile 11 per cent; Others 21 per cent Operation performed (rectal and rectosigmoid tumours):
Abdomino-perineal 12 per cent; Anterior resection 18 per cent; Surgeon (Consultant only): Range < 5 per cent to > 20 per cent. Stratification of the above variables altered only the statistical significance pertaining to tumour differentiation (P < 0·1, d.f. = 2). In particular, the differences between Consultant surgeons remained.