Desley van Zoggel

Chapter 4 64 Table 4. Univariate analysis Local re-recurrence HR CI P-value Age Up to 69 years 1.00 0.663 70 years or older 1.24 0.47-3.23 Gender Male 1.00 0.943 Female 1.03 0.42-2.57 Neoadjuvant treatment for LRRC Chemo(re)irradiation only 1.00 0.167 Induction chemo with chemo(re)irr. 0.36 0.08-1.54 Region of lateral local recurrence Obturator region 1.00 0.420 Internal iliac region 0.84 0.33-2.15 Common/external iliac region 0.35 0.07-1.67 Complete response Yes 1.00 0.219 No 3.53 0.47-26.5 Margin involvement R0 1.00 0.003 R+ 4.79 1.68-13.7 M-stage M0 1.00 0.119 M1 2.28 0.81-6.44 HR hazard ratio, CI confidence interval, NA not applicable. Measuring the largest diameter of the recurrences onMRI showed no difference in size between patientswho received ICT (largestmean diameter 38mm) versus patientswho hadno ICT (36mm; P =0.316). At the time of latLRdiagnosis, 15.4 percent of patientswho received ICT hadmetastases versus 18.4 percent in patients who had no chemotherapy (P = 0.804). No other factors (such as age, sex, adjuvant chemotherapy for primary tumour, etc.) that would support the choice for ICT were observed. Univariate and multivariate analyses Twenty patients developed an LRR, resulting in a 5-year LRR rate of 64.3 percent. The only factor influencing this was margin involvement (Table 4); patients who had an R+ resection had an almost fivefold higher chance of developing LRR (P = 0.003). All LRRs occurred in the lateral compartment. The5-yearDMratewas 59.8percent. Again, theonly factor that increasedDMwasmargin involvement (P = 0.031) (Table 4). CSS and OS were 35.7 and 34.2 percent, respectively. In univariate analyses, complete response and margin involvement both influenced CSS (Table 4), but after multivariate analyses, margin involvement was the only significant factor. There was an almost ninefold higher chance of death by cancer in