The impact of total mesorectal excision in middle and low rectal carcinomas.
OBJECTIVE
The incidence of locoregional recurrence in rectal cancer has declined since total mesorectal excision (TME) has been widely adopted. The purpose of this study was to investigate the long-term survival and the incidence of locoregional recurrences in patients with middle and low rectal carcinomas undergoing TME.


METHODS
The medical records of 126 patients with middle and low rectal carcinomas treated from 1987-2007 were retrospectively reviewed. Of them 80 had undergone total mesorectal excision (TME-group) and 46 surgery with conventional methods (CON-group). Clinical variables were correlated to morbidity, hospital mortality, recurrence, sites of recurrence, and survival.


RESULTS
The groups were comparable except for type of surgery and sites of recurrence. Five-year overall survival rate for TME group was 75% and for CON-group 47% (p=0.0346). Although the groups were not different for the total number of recurrences, the number of locoregional recurrences was significantly lower in TME group (p=0.004).


CONCLUSIONS
TME appears to improve long-term survival in patients with middle and low rectal carcinomas. The incidence of locoregional recurrence is also reduced by TME.
Tentes
A A K
AA
Department of Surgery, Didimotichon General Hospital, Didimotichon, Greece. atentes@did-hosp.gr
Korakianitis
O S
OS
Veliovic
D
D
Sgouridou
E
E
Karagiozoglou
C
C
Moustakas
K
K
D000368:Aged; D002277:Carcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011351:Proctoscopy; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012812:Sigmoidoscopy; D013997:Time Factors; D016896:Treatment Outcome