The Value of Tumor Size as a Prognostic Factor in Rectal Adenocarcinoma

Background: Colorectal cancer (CRC) is the third frequent diagnosed cancer and third cause of cancer death. Curative intent surgery followed by chemoradiotherapy are the standard of care for patients with CRC to reduce local recurrence and enhance overall survival (OS). This study aimed to evaluate tumor size as a prognostic factor for rectal adenocarcinoma local recurrence. Patients and Methods: This retrospective phase II study reviewed 100 rectal adenocarcinoma patients who were treated and followed up for 5 years after treatment. The medical records were reviewed for all cases including demographic data, medical history, personal habits, uncontrolled chronic medical condition, presenting symptoms and signs, pathological data, laboratory investigations, diagnosis, radiological examination, treatment details and treatment outcome assessed by OS and disease-free survival (DFS). Results: During 5 years of follow up in our study, 12 patients (12%) had local recurrence. Patients with tumor size > 5 cm has a significantly shorter DFS. DFS within 2-yrs for tumours ≤5 cm 96%, while 5-years DFS was 90%. While for tumours >5cm, 2-years DFS was 70% and 55% for 5-years and more. In tumours size >5cm, 2-years OS was 75%, 3-years OS was 72% and 5-years was 70% While In tumours ≤ 5cm, overall survival was 84%. Patients who had neoadjuvant chemoradiation also had a significant low local recurrent rate with (p=.042) in multivariate analysis. Conclusions: Tumor size has a prognostic value in rectal adenocarcinoma. Tumor size >5 cm is associated with higher rate of local recurrence and worse DFS.