• Masahiro Tanaka, Yukihide Kanemitsu, Dai Shida, Hiroki Ochiai, Shunsuke Tsukamoto, Masato Nagino, and Yoshihiro Moriya.
• 1 Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan 2 Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan 3 Surgery Division, Miki Hospital, Iwate, Japan.
• Dis. Colon Rectum. 2017 Aug 1; 60 (8): 827-836.

BackgroundThe influence of postoperative infectious complications, such as anastomotic leakage, on survival has been reported for various cancers, including colorectal cancer. However, it remains unclear whether intra-abdominal/pelvic inflammation after radical surgery for locally recurrent rectal cancer is relevant to its prognosis.ObjectiveThe purpose of this study was to evaluate factors associated with survival after radical surgery for locally recurrent rectal cancer.DesignThe prospectively collected data of patients were retrospectively evaluated.SettingsThis study was conducted at a single-institution tertiary care cancer center.PatientsBetween 1983 and 2012, patients who underwent radical surgery for locally recurrent rectal cancer with curative intent at the National Cancer Center Hospital were reviewed.Main Outcome MeasuresFactors associated with overall and relapse-free survival were evaluated.ResultsDuring the study period, a total of 180 patients were eligible for analyses. Median blood loss and operation time for locally recurrent rectal cancer were 2022 mL and 634 minutes. Five-year overall and 3-year relapse-free survival rates were 38.6% and 26.7%. Age (p = 0.002), initial tumor stage (p = 0.03), pain associated with locally recurrent rectal cancer (p = 0.03), CEA level (p = 0.004), resection margin (p < 0.001), intra-abdominal/pelvic inflammation (p < 0.001), and surgery period (p = 0.045) were independent prognostic factors associated with overall survival, whereas CEA level (p = 0.01), resection margin (p = 0.002), and intra-abdominal/pelvic inflammation (p = 0.001) were associated with relapse-free survival. Intra-abdominal/pelvic inflammation was observed in 45 patients (25.0%). A large amount of perioperative blood loss was the only factor associated with the occurrence of intra-abdominal/pelvic inflammation (p = 0.007).LimitationsThis study was limited by its retrospective nature and heterogeneous population.ConclusionsIntra-abdominal/pelvic inflammation after radical surgery for locally recurrent rectal cancer is associated with poor prognosis. See Video Abstract at http://journals.lww.com/dcrjournal/Pages/videogallery.aspx.

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