Oncological Results According to Type of Resection for Rectal Cancer

• Published in: Cirugia española (English ed.) 2015-04, Vol.93 (4), p.229-235
• Main Authors: Ciga Lozano, Miguel Ángel, Codina Cazador, Antonio, Ortiz Hurtado, Héctor
• Format: Article
• Language: English
• Subjects: Abdominoperineal resection; Amputación abdominoperineal; Cáncer de recto; Local recurrence; Metastases; Metástasis; Overall survival; Recidiva local; Rectal cancer; Supervivencia global; Surgery
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2014.06.012

Abstract Objective This multicentre observational study aimed to compare outcomes of anterior resection (AR) and abdominal perineal excision (APE) in patients treated for rectal cancer. Methods Between March 2006 and March 2009 a cohort of 1598 patients diagnosed with low and mid rectal cancer were operated on in the first 38 hospitals included in the Spanish Rectal Cancer Project. In 1343 patients the procedure was considered curative. Clinical and outcome results were analysed in relation to the type of surgery performed. All patients were included in the analysis of clinical results. The analysis of outcomes was performed only on patients treated by a curative procedure. Results Of the 1598 patients, 1139 (71.3%) were underwent an AR and 459 (28.7%) an APR. In 1343 patients the procedure was performed with curative intent; from these 973 (72.4%) had an AR and 370 (27.6%) an APR. There were no differences between AR and APR in mortality (29 vs 18 patients; P =.141). After a median follow up of 60.0 [49.0–60.0] months there were no differences in local recurrence (HR 1.68 [0.87–3.23]; P =.12) and metastases (HR 1.31 [0.98–1.76]; P =.064). However, overall survival was worse after APR (HR 1.37 [1.00–1.86]; P =.048). Conclusion This study did not identify abdominoperineal excision as a determinant of local recurrence or metastases. However, patients treated by this operation have a decreased overall survival.