Conservative management of invasive rectal cancer: alternative to abdominoperineal resection.
The standard treatment for patients with distal invasive rectal cancer who are unable to undergo a low anterior resection (LAR) is an abdominoperineal resection (APR). Although an APR offers excellent cure rates, it is associated with complications such as urological dysfunction, male impotence, and requires a permanent colostomy. Local excision alone is not adequate. If there is no evidence of gross disease in the pelvis, sphincter-sparing surgery (with negative margins) with adjuvant pelvic radiation therapy may be an alternative to abdominoperineal resection. Further follow-up will be needed to determine if this approach ultimately achieves local control and survival rates similar to an APR.
Minsky
B D
BD
Department of Radiation Oncology, Memorial Sloan-Kettering.
Cohen
A M
AM
D000005:Abdomen / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D010537:Peritoneum / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D011878:Radiotherapy / Q000379:methods; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012007:Rectum / Q000601:surgery*