Local pelvic-perineal recurrences were evaluated in 40 patients who underwent a sphincter-saving resection for rectal adenocarcinoma at Roswell Park Memorial Institute. The length of follow-up was at least 5 years or until death in all but one patient. There were 24 women and 16 men with a median age of 63 years. In 31 patients, the resection was considered to be curative and was considered palliative in the remaining 9 patients. Seven of the 31 patients (23 percent) developed a local recurrence. Two of the seven local recurrences had further resection for curative intent, with one person alive at 88 months. Margins of resection were available in 27 patients. Local recurrence occurred in 4 of 8 patients with distal margins of resection less than 2 cm and in 3 of 19 patients with margins greater than 2 cm. When the lesion was less than 10 cm from the anal verge, local recurrence was more likely to occur than at margins above this level.
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