The LARS score identified a substantial proportion of patients after surgery for rectal cancer with anorectal dysfunction. The extent of surgical procedure is independently associated with the severity of symptoms whereas the role of radiotherapy needs further assessment.

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ELAPE results in lower local recurrence rates as compared with conventional APE. We conclude that the extralevator approach should be the procedure of choice for advanced low rectal cancer not amenable to sphincter preserving procedures.

Background Synchronous metastases are considered a negative prognostic factor in patients with metastatic colorectal cancer (CRC). We investigated the outcomes of stage IV CRC patients undergoing complete gross resection (R0/1) of both the primary tumor and the metastases under the guidance of a multidisciplinary team (MDT). Methods All CRC patients with synchronous metastases were retrieved from a prospective database. Patients treated from 2006 to 2017 who underwent complete resection were analyzed. Various factors, including multiple metastatic sites and complex procedures, were investigated. Univariate and multivariate overall survival (OS) calculations were performed. Results Of 330 consecutive patients with synchronous metastases, 101 (30.6%) achieved an R0/1 status including 12 (11.9%) patients with multiple metastatic sites. Complex procedures were necessary in 45 (44.6%) patients. Five‐year OS was 53.0% for the R0/1 patient group. Multivariate analysis could not detect factors associated with prognosis. Conclusions With modern treatment, the prognosis of patients with synchronous CRC metastases can be improved. Decisions made by a MDT offered one‐third of patients a potentially curative approach to their stage IV disease. Despite the treatment of a high rate of patients with complex metastases necessitating complex procedures, we achieved a favorable 5‐year OS rate.

advanced stage disease). Ten patients had grade 2 (41.6%), 2 had grade 3 (8.3%), and 1 (4.2%) had grade 4 dermatitis in 40Gy group compared to 4 patients with grade 2(30.8%) and none with grade 3 or 4 dermatitis in 24Gy group (p Z 0.067). In the 40Gy group 5 patients (20.8%) had fair and 1 (4.2%) had poor cosmesis compared to none with fair or poor cosmesis in 24Gy group (p Z 0.059). Four patients (16.7%) progressed in the 40 Gy group compared to 2 patients (15.4%) in 24Gy group, however there was no statistically significant difference (p Z 0.603). Conclusion: This study is unique of its kind. 24Gy in 3 weekly fractions is safe and feasible with lesser side effects without compromise in response outcome compared to 40Gy in 5 weekly fractions in the treatment of advanced/fungating breast lesions.