Abdominoperineal resection is associated with poor oncological outcome
Background: The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non‐APR). Methods: Five hundred and four consecutive patients (30...
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| Veröffentlicht in: | British journal of surgery 2004-11, Vol.91 (11), p.1493-1499 |
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| creator | Law, W. L. Chu, K. W. |
| description | Background:
The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non‐APR).
Methods:
Five hundred and four consecutive patients (308 men and 196 women) with rectal cancer within 12 cm from the anal verge underwent radical resection with curative intent. Sharp mesorectal dissection was used. Operative results and long‐term outcomes were compared between those treated by APR and those by non‐APR.
Results:
Sixty‐nine patients had APR and 435 patients were treated with radical resection without perineal resection (anterior resection, 419; Hartmann's operation, 16). The overall operative mortality and morbidity rates were 1·6 and 31·0 per cent respectively. Age, sex, duration of surgery, blood loss, duration of hospital stay, operative mortality and overall morbidity were similar in the two groups. Local recurrence was more frequent after curative APR than after non‐APR (23 versus 10·2 per cent at 5 years; P = 0·010). Five‐year cancer‐specific survival rates after APR and non‐APR were 60 and 74·0 per cent respectively (P = 0·006). APR was an independent factor for poor cancer‐specific survival in multivariate analysis.
Conclusion:
Although postoperative mortality and morbidity rates were similar in patients with or without sphincter ablation, local control and survival were worse in those treated by APR. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Raises important issues concerning tumour clearance |
| doi_str_mv | 10.1002/bjs.4723 |
| format | Article |
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The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non‐APR).
Methods:
Five hundred and four consecutive patients (308 men and 196 women) with rectal cancer within 12 cm from the anal verge underwent radical resection with curative intent. Sharp mesorectal dissection was used. Operative results and long‐term outcomes were compared between those treated by APR and those by non‐APR.
Results:
Sixty‐nine patients had APR and 435 patients were treated with radical resection without perineal resection (anterior resection, 419; Hartmann's operation, 16). The overall operative mortality and morbidity rates were 1·6 and 31·0 per cent respectively. Age, sex, duration of surgery, blood loss, duration of hospital stay, operative mortality and overall morbidity were similar in the two groups. Local recurrence was more frequent after curative APR than after non‐APR (23 versus 10·2 per cent at 5 years; P = 0·010). Five‐year cancer‐specific survival rates after APR and non‐APR were 60 and 74·0 per cent respectively (P = 0·006). APR was an independent factor for poor cancer‐specific survival in multivariate analysis.
Conclusion:
Although postoperative mortality and morbidity rates were similar in patients with or without sphincter ablation, local control and survival were worse in those treated by APR. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Raises important issues concerning tumour clearance</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.4723</identifier><identifier>PMID: 15455362</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; General aspects ; Humans ; Laparotomy - methods ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - etiology ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Rectal Neoplasms - surgery ; Statistics, Nonparametric ; Survival Analysis ; Treatment Outcome</subject><ispartof>British journal of surgery, 2004-11, Vol.91 (11), p.1493-1499</ispartof><rights>Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright (c) 2004 British Journal of Surgery Society Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3863-e9ca0a2efca4b0cc3e5a06c53e854c91731d9361b3e9c2c32695d750a7866ea03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.4723$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.4723$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16245529$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15455362$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Law, W. L.</creatorcontrib><creatorcontrib>Chu, K. W.</creatorcontrib><title>Abdominoperineal resection is associated with poor oncological outcome</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non‐APR).
Methods:
Five hundred and four consecutive patients (308 men and 196 women) with rectal cancer within 12 cm from the anal verge underwent radical resection with curative intent. Sharp mesorectal dissection was used. Operative results and long‐term outcomes were compared between those treated by APR and those by non‐APR.
Results:
Sixty‐nine patients had APR and 435 patients were treated with radical resection without perineal resection (anterior resection, 419; Hartmann's operation, 16). The overall operative mortality and morbidity rates were 1·6 and 31·0 per cent respectively. Age, sex, duration of surgery, blood loss, duration of hospital stay, operative mortality and overall morbidity were similar in the two groups. Local recurrence was more frequent after curative APR than after non‐APR (23 versus 10·2 per cent at 5 years; P = 0·010). Five‐year cancer‐specific survival rates after APR and non‐APR were 60 and 74·0 per cent respectively (P = 0·006). APR was an independent factor for poor cancer‐specific survival in multivariate analysis.
Conclusion:
Although postoperative mortality and morbidity rates were similar in patients with or without sphincter ablation, local control and survival were worse in those treated by APR. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Raises important issues concerning tumour clearance</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Chemotherapy, Adjuvant</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General aspects</subject><subject>Humans</subject><subject>Laparotomy - methods</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy, Adjuvant</subject><subject>Rectal Neoplasms - surgery</subject><subject>Statistics, Nonparametric</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0E1PwzAMBuAIgWAMJH4B6gVuBSde0vUIgw0QH0IDwS1KUw8CbTOaToN_T6cNdvLBj17ZL2MHHE44gDjNPsJJLxG4wToclYwFV_1N1gGAJOYocIfthvABwBGk2GY7XPakRCU6bHiW5b50lZ9S7SoyRVRTINs4X0UuRCYEb51pKI_mrnmPpt7Xka-sL_ybs632s8b6kvbY1sQUgfZXs8ueh5dPg6v49mF0PTi7jS32FcaUWgNG0MSaXgbWIkkDykqkvuzZlCfI8xQVz7CVwqJQqcwTCSbpK0UGsMuOl7nT2n_NKDS6dMFSUZiK_CxolQBySNIWHq7gLCsp19Palab-0X-ft-BoBUxoH5nUprIurJ0SLRSLoHjp5q6gn_Ue9KJ53TavF83r85vxYq69Cw19_3tTf7bHYSL1y_1Iv96N4eUxvdCv-AtW6IRV</recordid><startdate>200411</startdate><enddate>200411</enddate><creator>Law, W. L.</creator><creator>Chu, K. W.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200411</creationdate><title>Abdominoperineal resection is associated with poor oncological outcome</title><author>Law, W. L. ; Chu, K. W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3863-e9ca0a2efca4b0cc3e5a06c53e854c91731d9361b3e9c2c32695d750a7866ea03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Chemotherapy, Adjuvant</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>General aspects</topic><topic>Humans</topic><topic>Laparotomy - methods</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy, Adjuvant</topic><topic>Rectal Neoplasms - surgery</topic><topic>Statistics, Nonparametric</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Law, W. L.</creatorcontrib><creatorcontrib>Chu, K. W.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Law, W. L.</au><au>Chu, K. W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abdominoperineal resection is associated with poor oncological outcome</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2004-11</date><risdate>2004</risdate><volume>91</volume><issue>11</issue><spage>1493</spage><epage>1499</epage><pages>1493-1499</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
The aim of this study was to compare the operative results and oncological outcomes of patients who had mid or distal rectal cancer treated by abdominoperineal resection (APR) with those treated without sphincter ablation (non‐APR).
Methods:
Five hundred and four consecutive patients (308 men and 196 women) with rectal cancer within 12 cm from the anal verge underwent radical resection with curative intent. Sharp mesorectal dissection was used. Operative results and long‐term outcomes were compared between those treated by APR and those by non‐APR.
Results:
Sixty‐nine patients had APR and 435 patients were treated with radical resection without perineal resection (anterior resection, 419; Hartmann's operation, 16). The overall operative mortality and morbidity rates were 1·6 and 31·0 per cent respectively. Age, sex, duration of surgery, blood loss, duration of hospital stay, operative mortality and overall morbidity were similar in the two groups. Local recurrence was more frequent after curative APR than after non‐APR (23 versus 10·2 per cent at 5 years; P = 0·010). Five‐year cancer‐specific survival rates after APR and non‐APR were 60 and 74·0 per cent respectively (P = 0·006). APR was an independent factor for poor cancer‐specific survival in multivariate analysis.
Conclusion:
Although postoperative mortality and morbidity rates were similar in patients with or without sphincter ablation, local control and survival were worse in those treated by APR. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Raises important issues concerning tumour clearance</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>15455362</pmid><doi>10.1002/bjs.4723</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Wiley Online Library All Journals |
| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Chemotherapy, Adjuvant Female Follow-Up Studies General aspects Humans Laparotomy - methods Length of Stay Male Medical sciences Middle Aged Neoplasm Recurrence, Local - etiology Proportional Hazards Models Radiotherapy, Adjuvant Rectal Neoplasms - surgery Statistics, Nonparametric Survival Analysis Treatment Outcome |
| title | Abdominoperineal resection is associated with poor oncological outcome |
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