Lymphatic Vessel Density as Predictive Marker for the Local Recurrence of Rectal Cancer

PURPOSE: This study identified possible factors affecting the frequency of local recurrence of rectal cancer, focusing on lymphangiogenesis as a predictor. METHODS: We examined 352 primary rectal cancer cases and 34 local recurrent specimens by lymphatic hyaluronan receptor. The lymphangiogenesis of all specimens was evaluated by measuring by lymphatic vessel density and other clinicopathologic factors. RESULTS: A multivariate analysis using the Cox proportional hazard model showed that lymphatic vessel density, lymph node metastasis, depth of invasion, and lymphatic invasion were significant independent predictive factors of local recurrence; lymphatic vessel density was the strongest predictor. In addition, a significant correlation was found between the lymphatic vessel density of the primary rectal cancer and the corresponding local recurrent cases. CONCLUSIONS: We suggest that rectal cancers, which have active lymphangiogenesis, also demonstrate a greater potential for local recurrence, and the lymphatic vessel density of surgical specimens is an independent risk factor and a valuable predictive factor for the local recurrence of rectal cancer.