title: Cancer of the low and middle rectum: local and distant recurrences, and survival in 350 radically resected patients.
abstract: The purpose of this study was to compare local recurrence, distant metastases, and survival rate in 350 patients with cancer of the middle and low rectum who underwent a radical abdominoperineal resection (APER) or a sphincter-saving resection (SSR) in our Institute. There were 257 APER patients and 93 SSR patients, with a median follow-up of 77 months. At 5 years, the estimates in APER and SSR patients were respectively 11% and 30% for the incidence of pelvic recurrence, 18% and 8% for the incidence of distant metastases, and 64% and 73% for overall survival. In the multivariate analysis it was found that Dukes' stage significantly affected pelvic recurrences, distant metastases rate and overall survival; histologic type affected only the pelvic recurrence rate. However, the final outcome of patients following APER or SSR was similar, suggesting that local failure per se does not affect long-term survival.
authors.affiliation: Division of Surgery of the Digestive Tract, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bozzetti
authors.forename: L
authors.initials: L
authors.lastname: Mariani
authors.forename: R
authors.initials: R
authors.lastname: Miceli
authors.forename: R
authors.initials: R
authors.lastname: Doci
authors.forename: F
authors.initials: F
authors.lastname: Montalto
authors.forename: S
authors.initials: S
authors.lastname: Andreola
authors.forename: L
authors.initials: L
authors.lastname: Gennari
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors