PURPOSE: This study was aimed to identify whether total mesorectal excision (TME) is a valid prognostic factor for recurrence following curative surgery for rectal carcinoma. METHODS: For 110 high-risk rectal carcinoma patients, recurrence rate and patterns of recurrence were compared between patients undergoing TME and those with classical dissection. RESULTS: Both local recurrence and distant metastasis were significantly lower in TME group than those in classical dissection group. Time interval from operation to the initial recurrence was also significantly delayed in TME group. By comaparing with other prognostic variables, TME was found to be a significant prognostic factor for the recurrence. CONCLUSIONS: We think TME is an important prognostic factor for the recurrence following curative resection in rectal carcinoma.