Local Recurrence After Curative Resection of Cancer of the Rectum Without Total Mesorectal Excision

dc.contributor.authorKillingback, Mark
dc.contributor.authorBarron, Prudence
dc.contributor.authorDent, Owen
dc.date.accessioned2015-12-10T23:08:48Z
dc.date.available2015-12-10T23:08:48Z
dc.date.issued2001
dc.date.updated2015-12-10T09:08:41Z
dc.description.abstractPURPOSE: The aim of this article was to examine local recurrence after curative resection for carcinoma of the rectum in which the surgical technique of total mesorectal excision was not performed. METHODS: A single surgeon managed the patients and the data collected prospectively. Total excision of the distal mesorectum was not performed in the upper third or mid rectum. RESULTS: From 1969 to 1993 curative resections were performed in 549 patients, of which 17 died postoperatively, leaving 532 for analysis. Sphincter-saving resection was performed in 468 patients (88 percent) and abdominoperineal excision in 58 (10.9 percent). The pathology stages (Dukes) were A, 158 (29.7 percent); B, 184 (34.7 percent); and C, 190 (35.7 percent). Five hundred seventeen patients (97.2 percent) were followed up for a minimum of five years. The median period of follow-up was 82 months. Local recurrence confined to the pelvis occurred in 17 patients, and local recurrence associated with distant metastases occurred in 24 patients. The total five-year local recurrence rate was 7.6 percent. Local recurrence was increased in Stage C tumors (P = <0.0001). Diathermy dissection in the pelvis was associated with a decreased local recurrence rate (P = 0.023). The five-year survival rate in curative resections was 72.5 percent. CONCLUSIONS: It is essential that articles presenting local recurrence rates should include both local recurrence in isolation and that which occurs with distant metastases. Although total mesorectal excision for rectal cancer was not performed in this study, the local recurrence rate is not materially different from that in several articles where total mesorectal excision has been used. Whether the distal mesorectum needs to be pursued in mid-rectal cancer is not yet proven.
dc.identifier.issn0012-3706
dc.identifier.urihttp://hdl.handle.net/1885/63256
dc.publisherWilliams & Wilkins
dc.sourceDiseases of the Colon and Rectum
dc.subjectKeywords: anus sphincter; article; cancer recurrence; cancer staging; cancer survival; human; major clinical study; metastasis; prognosis; rectum carcinoma; surgical technique; Adult; Aged; Aged, 80 and over; Digestive System Surgical Procedures; Female; Humans; Ma Curative; Local recurrence; Rectal cancer; Survival
dc.titleLocal Recurrence After Curative Resection of Cancer of the Rectum Without Total Mesorectal Excision
dc.typeJournal article
local.bibliographicCitation.issue4
local.bibliographicCitation.lastpage483
local.bibliographicCitation.startpage473
local.contributor.affiliationKillingback, Mark, Sydney Adventist Hospital
local.contributor.affiliationBarron, Prudence, Sydney Adventist Hospital
local.contributor.affiliationDent, Owen, College of Arts and Social Sciences, ANU
local.contributor.authoremailrepository.admin@anu.edu.au
local.contributor.authoruidDent, Owen, u7300926
local.description.notesImported from ARIES
local.description.refereedYes
local.identifier.absfor110323 - Surgery
local.identifier.ariespublicationMigratedxPub786
local.identifier.citationvolume44
local.identifier.scopusID2-s2.0-0035059881
local.identifier.uidSubmittedByMigrated
local.type.statusPublished Version

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