Discussion of QOL (with Concise Summary of Newer Clinical Research) in Colorectal Cancer Patients Treated in a Retrospective Trial on the Effect of Surgical Resection Margins on Survival, with Relation to Operation Type

Abstract

Background: the survival of patients treated for CRC is showing a trend of increase and with it increasing concern for the QOL of the operated patient. The aim of this study was to examine the relative influence of distal and circumferential resection margin lenght on survival among a select group patients (undergoing routine treatment) in our institution, with no metastases, and not operated on as an emergency. We also hoped to provide a concise reflection of newer clinical research on the topic.Methods: records of 303 patients, that were operated on between January 2009 and January 2014, were retrospectively reviewed for this study. Patients who underwent emergency surgery and those with metastases were excluded, which left 128 patients suitable for statistical analysis. Results: the number of survivors was noticeably higher than the number of deaths in all groups. Analysis with the Mann-Whitney-Wilcoxon test showed statistically significant differences (p < 0.05) in survival between the group with different CRM-s (p=0.01396), and could not be found between different DRM groups (p=0.1132). The logistic regression model of survival analysis showed that the size CRM is an independent predictor (p = 0.0202, AIC = 92.181) and the size of the DRM is not (p = 0.119, AIC = 109.89). Conclusions: a distal resection margin smaller than 1 cm may be oncologically acceptable in a complete R0 excision, which could theoretically help surgeons perform SSR operations with better oncological and functional results.