Wide perineal dissection and its effect on local recurrence following potentially curative abdominoperineal resection for rectal adenocarcinoma

Cancer Investigation
C VolpeN J Petrelli

Abstract

Ninety-three patients underwent a potentially curative abdominoperineal resection (APR) with a wide perineal dissection to the ischial tuberosities and excision of the entire mesorectum. There were 56 males and 37 females. The median follow-up was 67 months (range 7-240 months). The lymph node clearing technique was used and the median number of lymph nodes cleared was 35 (range 6-89). Eighteen of 93 patients (19%) developed a local recurrence, 12 of whom (13%) developed local recurrence only as the first site of recurrence. In 10 of 18 patients (56%) the distal rectum was the site of the primary rectal cancer. Of the 18 patients, 1 patient had stage I disease, 5 stage II, and 12 stage III. Five of the 18 patients (28%) who developed a local recurrence received adjuvant therapy. The median survival from the time of diagnosis of a local recurrence was 12 months. Histological grade (p=.001), patient age (p=.006), and presence of positive lymph nodes (p=.005) had a statistically significant adverse effect on survival. We believe the surgical technique of abdominoperineal resection with wide perineal resection to the ischial tuberosities and total excision of the mesorectum allowed us to achieve a low local recurrence rate (13%) in...Continue Reading

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Citations

Jan 1, 1991·Journal of Surgical Oncology. Supplement·L HerreraY Khalek
May 24, 2011·International Journal of Colorectal Disease·Sigmar StelznerHelmut Witzigmann
Dec 13, 2006·Diseases of the Colon and Rectum·Sushil MaslekarJohn E Hartley
Jun 6, 2006·World Journal of Surgical Oncology·Alain SermierPhilippe Morel
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Feb 10, 2006·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·A Radcliffe
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Nov 29, 2007·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Tijen AlkanAydn Aytaç
Dec 3, 2005·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Akif Undar

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