the influence of chemotherapy, radiation, and surgery on survival. Multivariable models were adjusted for patient and tumor characteristics. Results: We identified 2,522 cases of rectal SCC and 112,228 cases of rectal adenocarcinoma from the NCDB diagnosed between 2004 and 2013. Compared to those with rectal adenocarcinoma patients with rectal SCC were more likely to be younger, female, have Medicaid or no insurance, live in lower income regions, live in highly populated areas, treated in community practices, live in the East or Atlantic geographic region, and present with earlier stage but higher grade disease. Multivariable analysis adjusting for patient age, tumor stage, and other confounding variables found that the survival was better for patients with rectal SCC compared to rectal adenocarcinoma (hazard ratio [HR] Z 0.77, 95% CI 0.70-0.84). Among patients with stage I-III rectal SCC those receiving chemoradiation or trimodality therapy (chemotherapy, radiation, and surgery) had improved survival compared to those receiving surgery alone (HR Z 1.80, 95% CI 1.22-2.66) or radiation alone (HR Z 3.32, 95% CI 2.38-4.64). We found no difference in survival among those treated with chemoradiation or trimodality therapy (P>0.05). Conclusion: Squamous cell carcinoma is a rare cancer with better outcomes compared to rectal adenocarcinoma. Chemoradiation was associated with improved survival but selection bias or unobserved confounders could account for this finding given the non-randomized retrospective dataset.
INTRODUCTIONWe report the management and outcome of the case of a 57-year old woman with adenocarcinoma of the rectum. Following neo-adjuvant chemo-radiotherapy and laparoscopic-assisted anterior resection of her tumour she developed a right salpingo-ureteric fistula.PRESENTATION OF CASEThree weeks following laparoscopic anterior resection of the tumour she presented with urinary frequency and incontinence. A ureteric stent was inserted and left in-situ for five months but the fistula did not heal. The patient underwent exploration and open repair of the salpingo-ureteric fistula which resolved her symptoms.DISCUSSIONThere have not been many reported cases in the literature of salpingo-ureteric fistulae but after initial trial of management with ureteric stents all eventually required open exploration and repair.CONCLUSIONwe advocate open repair of salpingo-ureteric fistulae as the definitive management following intra-operative injury.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.