Oncological outcome of local vs radical resection of low-risk pT1 rectal cancer.
Arch Surg
; 142(7): 649-55; discussion 656, 2007 Jul.
Article
em En
| MEDLINE
| ID: mdl-17638803
ABSTRACT
HYPOTHESIS:
Despite the noninclusion of locally draining lymph nodes, limited resection of low-risk pT1 rectal cancer can achieve an adequate oncological outcome with lower morbidity and mortality compared with radical resection.DESIGN:
Based on the data of a prospective multicenter observational study performed from January 1, 2000, through December 31, 2001, patients with low-risk pT1 rectal cancer underwent analysis with regard to the early postoperative outcome and the oncological long-term results achieved after limited vs radical resection with curative intent.SETTING:
Two hundred eighty-two hospitals of all categories. PATIENTS Four hundred seventy-nine patients with low-risk pT1 rectal cancer treated for cure.INTERVENTIONS:
Eighty-five patients (17.7%) underwent limited excision using a conventional transanal approach and 35 (7.3%) using transanal endoscopic microsurgery. The remaining 359 (74.9%) underwent radical resection. MAIN OUTCOMEMEASURES:
Postoperative morbidity and mortality, local recurrence rate, and tumor-free and overall survival.RESULTS:
In comparison with radical resection, limited resection was associated with fewer general (25.1% vs 7.5%; P<.001) and specific (22.8% vs 9.2%; P<.001) postoperative complications. After a mean follow-up of 44 months, patients who underwent limited resection had a significantly higher 5-year local tumor recurrence rate than did those who underwent radical resection (6.0% vs 2.0%; P = .049), but tumor-free survival did not differ.CONCLUSION:
Limited resection of pT1 low-risk rectal cancer can result in an oncologically acceptable outcome but must nevertheless be considered an oncological compromise compared with radical resection.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Carcinoma
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Alemanha