Tech Coloproctol (2004) 8:S167–S169 DOI 10.1007/s10151-004-0146-5
S. Angelopoulos • I. Kanellos • N. Sapidis • K. Vasiliadis • A. Kanellou • D. Betsis
Survival after curative resection for rectal cancer by the end of the 20th century
Abstract Background The aim of this study was to define the survival rates in patients with rectal carcinoma treated with curative resections. Patients and methods Between 1993 and 1998, 54 patients with rectal cancer underwent curative resection by conventional technique. Tumour location, TNM staging and tumour differentiation were evaluated. Among the 54 patients, 14 underwent high anterior resection, 28 low anterior resection, 7 abdominoperineal resection and 5 underwent local excision. Survival rates were calculated using the KaplanMeier method and long-range analysis. Results Five-year survival was 70.4%. The survival rate statistically significantly decreased with increasing TNM tumour stage (p=0.009). Patients with poor differentiation of the tumour had the lowest 5-year survival (33%) compared to patients with moderate (72%) and good (78%) tumour differentiation. Sex and age did not affect survival.
Location of the tumour in the distal end of the rectum and mucinous characteristics are poor prognostic factors affecting survival. Conclusions Curative resection combined with chemoradiotherapy, whenever necessary, is accompanied with acceptable 5-year survival rates. Key words Rectal cancer Survival
•
Multimodal treatment
•
Introduction Despite the improvement in diagnosis and treatment of rectal cancer, it represents a significant source of morbidity and mortality worldwide [1]. However, within the last decade, surgical quality and prognosis after curative resection for rectal cancer has been improved and with the introduction of total mesorectal excision (TME), survival rates have increased significantly [2]. In addition, chemotherapy and radiation combined with curative resection in patients with rectal cancer have been shown to increase the overall survival [1]. The aim of the present study was to define survival rates in patients with rectal cancer treated with curative resections.
Patients and methods S. Angelopoulos • I. Kanellos • N. Sapidis • K. Vasiliadis A. Kanellou • D. Betsis 4th Surgical Department Aristotle University, Thessaloniki, Greece I. Kanellos () Antheon 1 Panorama 55236, Thessaloniki, Greece E-mail:
[email protected]
Between 1993 and 1998, a total of 54 patients underwent curative surgical procedures for rectal cancer. There were 29 females and 25 males, the average age being 65.8 years (range 42–74). Among 54 patients, 14 underwent high anterior resection, 28 low anterior resection, 7 abdominoperineal resection and 5 transanal tumour excision. All patients were operated on with a curative intention. The resection borders were free of tumour cells at histologic examination. Patients with cancer of the mid and low rectum were
S168
S. Angelopoulos et al.: Survival after resection for rectal cancer
operated on according to the concept of TME, which represented excision of the tumour including the entire mesorectum and its investing fascia intact. Selection criteria for transanal tumour excision were: Tis or T1, mobile, exophytic, well or moderately differentiated tumour
