Outcome of abdominosacral resection for locally advanced primary and recurrent rectal cancer.
Br J Surg
; 99(10): 1453-61, 2012 Oct.
Article
em En
| MEDLINE
| ID: mdl-22961529
ABSTRACT
BACKGROUND:
The aim was to assess the indications for and outcomes of abdominosacral resection for patients with locally advanced primary and recurrent rectal cancer.METHODS:
Consecutive patients undergoing abdominosacral resection between January 2006 and December 2011 were identified from a prospectively maintained database. The main endpoints were 3-year local recurrence-free (LRFS) and disease-free (DFS) survival.RESULTS:
Thirty patients underwent abdominosacral resection, 22 for recurrent rectal cancer and eight for locally advanced primary cancer. Sacrectomy was performed at S1/2 in five, S3 in 11 and S4/5 in 14 patients. R0 resection was achieved in 23 patients; all seven positive margins (R1) were in patients with recurrent disease. There were no deaths in hospital or within 30 days. S1/2 sacrectomy was associated with the highest rate of major complications (60 per cent versus 27 and 29 per cent for S3 and S4/5 respectively) and long-term complications (60, 36 and 14 per cent). Overall 3-year LRFS was 66 per cent and 3-year DFS was 55 per cent. Both were significantly better in patients with negative compared with positive margins (LRFS 87 versus 0 per cent, P < 0.001; DFS 71 versus 0 per cent, P = 0.033).CONCLUSION:
Abdominosacral resection was associated with long-term survival in carefully selected patients with advanced rectal cancer. Postoperative complications were common and often multiple. Sacrectomy for locally advanced primary rectal cancer was associated with a low margin-positive rate and should be considered as an acceptable treatment. Margin-positive resection was associated with poor survival outcomes and should be avoided.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Região Sacrococcígea
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Abdome
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Recidiva Local de Neoplasia
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article