title: Oncological results according to type of resection for rectal cancer.
abstract: OBJECTIVE
  This multicentre observational study aimed to compare outcomes of anterior resection (AR) and abdominal perineal resection (APR) in patients treated for rectal cancer.
  
  
  METHODS
  Between March 2006 and March 2009 a cohort of 1,598 patients diagnosed with low and mid rectal cancer were operated on in the first 38 hospitals included in the Spanish Rectal Cancer Project. In 1,343 patients the procedure was considered curative. Clinical and outcome results were analysed in relation to the type of surgery performed. All patients were included in the analysis of clinical results. The analysis of outcomes was performed only on patients treated by a curative procedure.
  
  
  RESULTS
  Of the 1,598 patients, 1,139 (71.3%) underwent an AR and 459 (28.7%) an APR. In 1,343 patients the procedure was performed with curative intent; from these 973 (72.4%) had an AR and 370 (27.6%) an APR. There were no differences between AR and APR in mortality (29 vs. 18 patients; P=.141). After a median follow up of 60.0 [49.0-60.0] months there were no differences in local recurrence (HR 1.68 [0.87-3.23]; P=.12), metastases (HR 1.31 [0.98-1.76]; P=.064). However, overall survival was worse after APR (HR 1.37 [1.00-1.86]; P=.048).
  
  
  CONCLUSIONS
  This study did not identify abdominoperineal excision as a determinant of local recurrence or metastases. However, patients treated by this operation have a decreased overall survival.
authors.affiliation: Unidad de Cirugía Colorrectal, Servicio de Cirugía General, Complejo Hospitalario de Navarra, Pamplona, España. Electronic address: ma.ciga.lozano@cfnavarra.es.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Ciga Lozano
authors.affiliation: Departamento de Cirugía, Hospital Josep Trueta, Girona, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Codina Cazador
authors.affiliation: Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, España.
authors.forename: Héctor
authors.initials: H
authors.lastname: Ortiz Hurtado
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: Abdominoperineal resection; Amputación abdominoperineal; Cáncer de recto; Local recurrence; Metastases; Metástasis; Overall survival; Recidiva local; Rectal cancer; Supervivencia global