Oncological Outcomes After Total Mesorectal Excision for Cure for Cancer of the Lower Rectum: Anterior vs. Abdominoperineal Resection

• DOI: 10.1007/s10350-003-0012-y
• Publication Date: 2004-07-22T00:50:44Z
• Authors: Arne Wibe; Astri Syse; Elisabeth Andersen; Steinar Tretli; Helge E. Myrvold; Odd Søreide
• Keywords: Abdominoperineal resection; Anal verge

This study was designed to examine the outcome of cancer lower rectum, particularly rates local recurrence and survival for tumors located in this area that have been treated by anterior or abdominoperineal resections.A prospective, observational, national, cohort which is part Norwegian Rectal Cancer Project. The present includes all patients undergoing total mesorectal excision 47 hospitals during period November 1993 December 1999. A 2,136 with rectal within 12 cm anal verge were analyzed; there 1,315 (62 percent) resections 821 (38 resections. edge tumor 0 5 from 791 patients, 6 8 558 9 787 patients. According TNM classification, 33 percent Stage I, 35 II, 32 III.Univariate analyses: five-year rate 15 level, 13 intermediate upper level (P=0.014). It 10 after resection (P=0.008). 59 62 69 (P<0.001), respectively, it 68 anterior-resection group 55 abdominoperineal-resection (P<0.001). Multivariate influenced risk (hazard ratio, 1.8; 95 confidence interval, 1.1-2.3), but operative procedure, vs. resection, did not 1.2; 0.7-1.8). On contrary, procedure 1.3; 1-1.6), 1.1; 0.9-1.5). In addition patient characteristics (T4 tumors), intraoperative bowel perforation involvement circumferential margin identified as significant prognostic factors, more common explaining inferior prognosis region.T4 tumors, R1 resections, and/or wall are main features low cancers, causing oncologic outcomes area. If surgery optimized, preventing margin, cancers rectum seems be inherently different at higher levels. case, type will indicators selecting radiotherapy.