[Comparative study of clinical efficacy between abdominoperineal resection and anterior resection procedure in patients with rectal cancer].
OBJECTIVE
To compare clinical efficacy between abdominoperineal resection (APR) procedure and anterior resection(AR) procedure in patients with rectal cancer.


METHODS
Clinicopathological data of 309 cases with rectal cancer undergoing resection in Peking University People's Hospital from January 1998 to December 2012 were retrospectively analyzed. Short-term outcomes, local recurrence, overall survival (OS) and progression-free survival (PFS) were investigated between two groups.


RESULTS
As compared to the AR group, the operative time was longer [(268.5 ± 66.7) min vs. (247.4 ± 64.2) min, P=0.005], blood loss[(668.5 ± 680.1) ml vs.(441.8 ± 478.6) ml, P=0.001] and drainage volume were more[(66.9 ± 54.7) ml vs. (49.0 ± 45.9) ml, P=0.002] in the APR group. There was no significant difference of local recurrence between the two groups, while the 5-year local recurrence rate of T3-T4 patients undergoing APR procedure (24.9%) was higher than that of AR group (13.9%)(P=0.038), especially in the patients with tumors located at 4-6 cm away from the anus verge. There were no significant differences of OS (P=0.273) and PFS (P=0.589) between two groups, while both 5-year OS and PFS of T3-T4 patients with BMI ≥ 24 undergoing APR procedure (43.1% and 42.8%) were significantly worse than those of patients undergoing AR procedure (87.9% and 76.9%, P=0.022 and P=0.041).


CONCLUSIONS
The overall prognosis of patients after APR and AR is comparable. Tumor located at 4-6 cm away from the anus verge, T3-T4 stage, obese may play an important role in the worse prognosis of the patients undergoing APR procedure.
Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China. yeyingjiang@pkuph.edu.cn;shwang60@sina.com.
Zhanlong
Z
Shen
Yingjiang
Y
Ye
Xin
X
Zhang
Qiwei
Q
Xie
Mujun
M
Yin
Xiaodong
X
Yang
Kewei
K
Jiang
Bin
B
Liang
Shan
S
Wang
D000005:Abdomen; D013505:Digestive System Surgical Procedures; D018572:Disease-Free Survival; D006801:Humans; D012004:Rectal Neoplasms; D012007:Rectum; D012189:Retrospective Studies; D016896:Treatment Outcome