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Surgical outcomes after total mesorectal excision for rectal cancer
Author(s) -
Chiappa Antonio,
Biffi Roberto,
Bertani Emilio,
Zbar Andrew P.,
Pace Ugo,
Crotti Cristiano,
Biella Francesca,
Viale Giuseppe,
Orecchia Roberto,
Pruneri Giancarlo,
Poldi Davide,
Andreoni Bruno
Publication year - 2006
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.20518
Subject(s) - medicine , anal verge , total mesorectal excision , abdominoperineal resection , colorectal cancer , surgery , stage (stratigraphy) , rectum , survival rate , cancer , paleontology , biology
Abstract Background and Objectives This study reviewed the results of surgery for distal rectal cancer following the introduction of total mesorectal excision (TME) for rectal cancer. Methods Two hundred sixty‐four patients who had undergone elective curative surgical resection of rectal cancer within 12 cm of the anal verge were included. Comparisons were made between patients who had different surgical procedures. Results The overall operative mortality rate was nil, and the morbidity 39.4%. With a mean follow‐up of 34 months (range 5–105 months), local recurrence occurred in 21 of the patients. The 3‐ and 5‐year actuarial local recurrence rates were 9% and 12%, respectively for the whole group. Abdominoperineal resection (APR) was necessary in 65 of 264 (24.6%) of the patients, with a very low local recurrence rate in this subgroup (5% at 3 years). On multivariate analysis, only stage was a significant prognosticator of overall survival ( P = 0.012). Conclusions With the practice of TME, APR was still necessary in 25% of patients with rectal cancer within 12 cm of the anal verge. Type of surgery and tumor distance from the anal verge influenced local recurrence rates, but only initial tumor stage was associated with long‐term survival. J. Surg. Oncol. 2006;94:182–193. © 2006 Wiley‐Liss, Inc.