Sphincter-saving resection, or not, for cancer of the midrectum.
BACKGROUND
The purpose of this study was to compare the time to pelvic recurrence and survival after sphincter-saving resection (SSR) or abdominoperineal resection (APR).


METHODS
Out of the 119 patients with a cancer of the midrectum, 43 had undergone a SSR and 76 an APR for cure. To eliminate bias of a nonrandomized retrospective comparison, an adjustment for baseline prognostic covariates was used.


RESULTS
Pelvic recurrence rates and survival distribution according to the type of resection did not differ significantly, with P values of 0.31 and 0.95, respectively, by the log-rank test. The Cox regression model incorporated nine binary covariates and the treatment group. Given these nine covariates, treatment did not influence either pelvic recurrence (adjusted P value = 0.62, relative risk = 0.78) or overall survival (adjusted P value = 0.89, relative risk = 1.05).


CONCLUSIONS
These results suggest that, in patients with cancer of the midrectum treated by SSR or APR, recurrence and survival rates are similar.
Huguier
M
M
Department of Surgery, Hôpital Tenon, Université Paris VI, France.
Chastang
C
C
Houry
S
S
Sima
A M
AM
Berhouet
H
H
Chevret
S
S
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008722:Methods; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000473:pathology; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate