Abdominosacral resection: Long-term outcome in 86 patients with locally advanced or locally recurrent rectal cancer
Abdominosacral resection: Long-term outcome in 86 patients with locally advanced or locally recurrent rectal cancer
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DOI：
10.1016/j.ejso.2014.02.233
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发表时间：
2014-06-01
期刊：
影响因子：
3.8
通讯作者：
Rutten, H. J. T.
中科院分区：
文献类型：
--
作者：
Bosman, S. J.;Vermeer, T. A.;Rutten, H. J. T.
目的：本研究的目的是评估腹骶切除术（ASR）在局部进展期或复发性直肠癌患者中的结局。方法：从1994年到2012年，局部进展期直肠癌（LARC）和局部复发性直肠癌（LRRC）患者接受了根治性ASR，并纳入数据库。结果：72例LRRC患者（平均年龄63岁;男44例，女28例）和14例LARC患者（平均年龄65岁;男6例，女8例）接受了ASR。37例LRRC患者和11例LARC患者实现RU切除。27例患者接受了R1切除术（LARC组3例）。8例患者行R2切除术，而LARC组无患者。LRRC组和LARC组分别有26例和1例患者发生3级或4级并发症，30天死亡率分别为3%和7%。5年总生存率分别为28%和24%。结论：直肠癌根治性切除术仍是治疗背侧复发性直肠癌的主要方法。经过彻底的患者选择，ASR是一种安全的手术，显示出可接受的发病率，并导致良好的肿瘤结局。(c)2014爱思唯尔有限公司版权所有。
Aims: The purpose of this study is to evaluate the outcome of abdorninosacral resections (ASR) in patients with locally advanced or recurrent rectal cancer.Methods: From 1994 until 2012 patients with locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) underwent a curative ASR and were enrolled in a database. The postoperative complication rates, predictive factors on oncological outcome and survival rates were registered.Results: Seventy-two patients with LRRC (mean age 63; 44 male, 28 female) and 14 patients with LARC (mean age 65; 6 male, 8 female) underwent ASR. RU resection was achieved in 37 patients with LRRC and 11 patients with LARC. Twenty-seven patients underwent an R1 resection (3 in the LARC group). Eight patients had an R2 resection, compared to no patients in the LARC group. In respectively 26 and 1 patients of the LRRC and LARC groups a grade 3 or 4 complication occurred and the 30-days mortality rate was respectively 3% and 7%. The 5-years overall survival was 28% and 24% respectively.Conclusion: En bloc radical resection remains the primary goal in the treatment of dorsally located (recurrent) rectal cancer. After thorough patient selection, ASR is a safe procedure to perform, shows acceptable morbidity rates and leads to a good oncological outcome. (c) 2014 Elsevier Ltd. All rights reserved.