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Outcomes in the surgical treatment of low rectal cancer: does neoadjuvant treatment equalize results?
Author(s) -
Pollett William G.,
Gibbs Peter,
McLaughlin Stephen,
Eteuati Jimmy,
Harold Michael,
Marion Kaye,
Patel Shweta,
Jones Ian
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12786
Subject(s) - medicine , rectum , colorectal cancer , surgery , neoadjuvant therapy , radiation therapy , cancer , breast cancer
Background The choice of operation for potentially curable cancer of the low rectum (≤6 cm from the anal verge) is usually between ultra low anterior resection ( ULAR ) or abdominal perineal excision ( APE ). Numerous studies have suggested improved results with ULAR . Methods This study was a retrospective review of prospectively collected data for a series of patients undergoing surgical treatment for low rectal cancer at three M elbourne hospitals. The patient details and outcomes were compared between those undergoing APE and ULAR . Results One hundred and ninety‐eight of 213 patients with potentially curable low rectal cancer were treated by either ULAR ( n = 82) or APE ( n = 116). Overall survival and local recurrence rates were similar, although there was a trend towards improved results for ULAR . Preoperative radiation was received by 89 (76.7%) of APE patients and 44 (53.7%) of ULAR patients ( P < 0.0005). Conclusion In this study there was no statistical difference in the oncological results between APE and ULAR . However, there was a trend to improved result for ULAR in spite of a strikingly higher rate of neoadjuvant radiation in the APE group. It is possible that enhanced use of preoperative radiation has a beneficial role in the management of low rectal cancer treated by conventional APE .