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Survival analysis of local excision vs total mesorectal excision for middle and low rectal cancer in pT1/pT2 stage and intermediate pathological risk.
- Source :
-
World journal of surgical oncology [World J Surg Oncol] 2019 Dec 09; Vol. 17 (1), pp. 212. Date of Electronic Publication: 2019 Dec 09. - Publication Year :
- 2019
-
Abstract
- Background: Local excision (LE) is a feasible treatment approach for rectal cancers in stage pT1 and presents low pathological risk, whereas total mesorectal excision (TME) is a reasonable treatment for more advanced cancers. On the basis of the pathology findings, surgeons may suggest TME for patients receiving LE. This study compared the survival outcomes between LE with/without chemoradiation and TME in mid and low rectal cancer patients in stage pT1/pT2, with highly selective intermediate pathological risk.<br />Methods: This retrospective study included 134 patients who received TME and 39 patients who underwent LE for the treatment of intermediate risk (pT1 with poor differentiation, lymphovascular invasion, perineural invasion, relatively large tumor, or small-sized pT2 tumor) rectal cancer between 1998 and 2016.<br />Results: Overall survival (OS), disease-free survival (DFS), and cumulative recurrence rate (CRR) were similar between the LE (3-year DFS 92%) and TME (3-year DFS 91%) groups. Following subgrouping into an LE with adjuvant therapy group and a TME without adjuvant therapy group, the compared survival outcomes (OS, DFS, and CRR) were found not to be statistically different. The temporary and permanent ostomy rates were higher in the TME group than in the LE group (p < 0.001). Rates of early and late morbidity following surgery were higher in the TME group (p = 0.005), and LE had similar survival compared with TME.<br />Conclusion: For patients who had mid and low rectal cancer in stage pT1/pT2 and intermediate pathological risk, LE with chemoradiation presents an alternative treatment option for selected patients.
- Subjects :
- Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local surgery
Neoplasm Staging
Rectal Neoplasms pathology
Rectal Neoplasms surgery
Retrospective Studies
Survival Rate
Treatment Outcome
Digestive System Surgical Procedures classification
Digestive System Surgical Procedures mortality
Neoplasm Recurrence, Local mortality
Rectal Neoplasms mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1477-7819
- Volume :
- 17
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- World journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 31818295
- Full Text :
- https://doi.org/10.1186/s12957-019-1763-9