title: Prognostic factors and preoperative radiation therapy associated with sphincter preservation in patients with resectable rectal cancer.
abstract: BACKGROUND
  This study evaluates the importance of patient and tumor factors, receipt of preoperative radiation therapy, and American Joint Committee on Cancer stage for sphincter preservation (SP) in patients with rectal cancer.
  
  
  METHODS
  Age, sex, race, body mass index, tumor size, distance from the anal verge (DAV), differentiation, American Joint Committee on Cancer stage, and preoperative radiation were evaluated. The end point was continence versus colostomy. Comparison was done by logistic regression; data were presented as mean +/- SEM; and significance was defined as P <.05.
  
  
  RESULTS
  Factors independently associated with SP were greater DAV, body mass index (BMI) <30, smaller tumor, and preoperative radiation therapy (all P <.05).
  
  
  CONCLUSIONS
  DAV remains the most important factor for prediction of SP in patients with rectal cancer. Preoperative tumor size and BMI were also independent factors. Preoperative radiation therapy may increase the chance of SP in patients with large tumors, increased BMI, or low rectal tumors.
authors.affiliation: Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35243, USA.
authors.forename: J Harrison
authors.initials: JH
authors.lastname: Howard
authors.forename: Quintin
authors.initials: Q
authors.lastname: Gonzalez
authors.forename: J Pablo
authors.initials: JP
authors.lastname: Arnoletti
authors.forename: Suzanne
authors.initials: S
authors.lastname: Russo
authors.forename: John B
authors.initials: JB
authors.lastname: Fiveash
authors.forename: Kirby I
authors.initials: KI
authors.lastname: Bland
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Heslin
mesh_terms: D001003:Anal Canal; D000704:Analysis of Variance; D000714:Anastomosis, Surgical; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003082:Colectomy / Q000379:methods*; D003125:Colostomy / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis