Multivisceral resections for locally advanced rectal cancer

• Published in: Colorectal disease Vol. 10; no. 5; pp. 453 - 459
• Main Authors: Derici, H., Unalp, H. R., Kamer, E., Bozdag, A. D., Tansug, T., Nazli, O., Kara, C.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2008
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - surgery; Adult; Aged; Female; Humans; Lymphatic Metastasis; Male; Middle Aged; Multivariate Analysis; multivisceral resection; Neoplasm Invasiveness; overall survival; Rectal carcinoma; Rectal Neoplasms - mortality; Rectal Neoplasms - surgery; Survival Rate
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/j.1463-1318.2007.01427.x

Objective  The aim of this study was to evaluate the effectiveness of en bloc multivisceral resection of organs involved by locally advanced rectal carcinoma. Method  A total of 312 patients with primary rectal cancer underwent surgery between January 1994 and April 2005. Of these, 57 patients (18.3%) had macroscopically direct invasion of an adjacent organ or structure, and underwent multivisceral resection with curative intent. Survival analyses were made by the Kaplan–Meier and the Cox proportional hazards regression model. Results  The postoperative mortality was 3.5%. The overall survival rate at 1, 3 and 5 years was 96.4%, 81.6% and 49.0%. Age (≥65 years), depth of tumour invasion (pT3 stage), lymph node status (pN0), tumour stage (III A–B), grading (G1), vascular and neural invasion (not extensive), type of adhesion (inflammatory) and type of resection (R0) were significant factors favouring survival in the univariate analysis. Only two factors, lymph node status pN0 (P = 0.007) and R0 resection (P = 0.005) were independently significant factors in the multivariate analysis. Conclusion  R0 resection and pN0 status influence overall survival for locally advanced rectal carcinoma.