Objective:

To define the time distribution of recurrence after curative surgery for stage I-III rectal cancer, identify factors associated with early recurrence, and examine their links with long-term outcomes and recurrence patterns.

Approach:

Key Findings:

• Recurrence hazard peaked at approximately 24 months after surgery.
• Lymph node ratio (LNR) and T4 stage were identified as independent correlates of early recurrence.
• Distant metastasis consistently exceeded local recurrence during follow-up.
• LNR and T4 stage were associated with worse time-to-recurrence and overall survival.

Interpretation:

Limitations:

• The local-recurrence model was exploratory due to limited events.
• Study conducted at a single center, which may limit generalizability.

Conclusion:

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