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Is abdominoperineal resection a good option for stage IV adenocarcinoma of the distal rectum?
Author(s) -
Chu Quyen D.,
Davidson Robert S.,
RodriguezBigas Miguel A.,
Wirtzfeld Debrah A.,
Petrelli Nicholas J.
Publication year - 2002
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.10135
Subject(s) - medicine , abdominoperineal resection , rectum , adenocarcinoma , stage (stratigraphy) , surgery , colorectal cancer , cancer , paleontology , biology
Background and Objectives The management of the primary lesion in patients with stage IV adenocarcinoma of the distal rectum is controversial. An abdominoperineal resection (APR) may be a good option. Methods A retrospective analysis of the medical records of 21 patients with stage IV distal rectal adenocarcinoma treated with an APR between January 1991 to December 2000 was performed. Results All patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 1 and normal preoperative alkaline phosphatase and total bilirubin levels. Twelve patients (92%) with liver metastases had less than 25% of total liver volume involvement. Twenty patients (95%) had complete resolution of their symptoms related to the primary rectal cancer. The median follow‐up was 19 months (range 3–92 months), with a median survival of 21.6 months and a 2‐year overall survival of 34%. Conclusions Patients with stage IV distal rectal adenocarcinoma who have a good performance status, normal preoperative liver function tests, and minimal metastatic disease to the liver can be offered resective surgery. J. Surg. Oncol. 2002;81:3–7. © 2002 Wiley‐Liss, Inc.