Survival and recurrence after low anterior resection and abdominoperineal resection for rectal cancer: The results of a long-term study with a review of the literature

Abstract

Morbidity, survival, and recurrence in 203 patients treated with curative low anterior resection (LAR) were compared with those in 100 patients treated with curative abdominoperineal resection (APR). The overall 5-year survival figures for the total number of, LAR and APR patients were 75.6 +/- 5.7%, 79.8 +/- 6.4% and 67.7 +/- 9.6%, respectively. The prognosis for cancers situated low enough in the rectum to involve the anal canal was poor even when managed by APR, as evidenced by a low survival at 5 years of 59.0 +/- 9.6% and a high pelvic recurrence rate of 34%. For all except these tumors, LAR proved at least equal to, or better than APR as a curative surgical method for middle and low rectal cancers, on the basis of 5-year survival being 79.8 +/- 6.4% vs 78.7 +/- 5.2%, operative mortality being 1.5% vs 1.0%, morbidity being 39.4% vs 59.0%, and the incidence of pelvic recurrence being 8.9% vs 13.5%. When deciding upon the most appropriate surgical procedure for rectal cancer, especially for middle or low rectal lesions, the patient should not simply be condemned to a permanent colostomy. Thus, we first attempt LAR for every lesion except those which are very advanced or those with anal canal involvement, if technically feasible and suitable for the individual patient.

Prognostic Significance of p21 and p27 Protein, Apoptosis, Clinical and Histologic Factors in Rectal Cancer without Lymph Node Metastases

“…Consequently, identification of prognostic factors to predict individual outcome, to select appropriate adjuvant treatment and follow-up options, and, finally, to analyze and compare treatment results is a crucial issue [22]. It is known that recurrence rates reported after resection for rectal cancer is commonly higher than after colon carcinoma and differences in prognosis have also been reported between high and low rectal carcinomas [23][24][25]. Risk factors that have previously been associated with increased recurrence rates in rectal cancer include patient age, gender, tumor stage, tumor size, lymph node involvement, type of surgery, radial resection margins in TME specimen, among others [9,16,17].…”

Retrospective review of rectal cancer surgery in northern Alberta

“…This is an important finding in that this has been shown to improve morbidity and to be associated with improved LR. 23 There was also a lower transfusion rate in the colorectal surgeon group, which may imply higher-quality surgery with less blood loss.…”

Cancer of the middle third of rectum – which operation choose? – Low anterior resection.

“…По данным исследований, посвященных сравнению результатов ССО и БПЭ, послео-перационная летальность составляет 1-2 %, частота несостоятельности анастомоза после резекции 5 %, количество осложнений 39,4 % при ССО и 59,0 % при БПЭ [25,65]. 5-летняя выживаемость составляет 71-79,8 % при ССО и 56-78,7 % при БПЭ [25,46].…”

“…5-летняя выживаемость составляет 71-79,8 % при ССО и 56-78,7 % при БПЭ [25,46]. Безрецидивная выживаемость составляет 70-78 % для пациен-тов, перенесших ССО и 54-80 % для пациентов, которым выполнялась БПЭ [46,65].…”

“…Безрецидивная выживаемость составляет 70-78 % для пациен-тов, перенесших ССО и 54-80 % для пациентов, которым выполнялась БПЭ [46,65]. Частота местного рецидива 3-8,9 % при ССО и 4-13,5 % при выполнении БПЭ [9, 24,25,46,65]. Ме-диана до развития рецидива составила 13-18 месяцев для ССО и 17 месяцев для БПЭ, без-рецидивная выживаемость -121-135 месяцев в группе ССО и 100 месяцев в группе БПЭ [9].…”