Parameters associated with survival in patients undergoing surgical treatment due to rectal cancer
Parameters associated with survival in patients undergoing surgical treatment due to rectal cancer
Aim: Colorectal cancer is the third most common type of cancer.Approximately 1/3 of colorectal cancers are rectum cancers. Thepercentage of local disease stage is 39%, and the 10-year survival rate in such patients is approximately 90%. The aim of our studywas to evaluate the relationship between the clinicopathological characteristics and survival of patients with rectal cancer.Material and Methods: Patients who had undergone surgical treatment for rectal cancer in our clinic between January 2008 andDecember 2013 were evaluated retrospectively. The effects of clinicopathological parameters of these patients on survival wereinvestigated. The preoperative and postoperative variables were evaluated together with survival data.Results: Of the 70 patients, 30 (43%) were females and 40 (57%) were males. The median age was 61 years (min-max = 29-87 years).Eight of the patients (6%) were operated under emergency conditions due to acute abdomen or ileus. 13 (19%) of the patients hadundergone laparoscopic surgery and 57 (81%) had undergone open surgical resection. 15 patients (21%) had undergone anteriorresection (AR), 51 (73%) had lower anterior resection (LAR) and 4 (6%) had abdomino-perineal resection (APR). According to pTNMstaging, 6 patients (8%) were at stage-0, 7 (10%) were at stage-I, 22 (32%) were at stage-II, 26 (37%) were at stage-III, and 9 (13%)were at stage IV.Conclusion: We found that the ASA (American society of Anesthesiologists) score height, final stage of the tumor and vascular(venous) invasion associated with overall survival
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- 1. Boyle P, Ferlay J. Cancer incidence and mortality in Europe,
2004. Ann Oncol 2005;16:481-8.
- 2. Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and
survivorship statistics, 2016. CA Cancer J Clin 2016;66:271-89.
- 3. SEER Stat Fact Sheet; colon and rectum. National Cancer
Institute http://seer.cancer.gov/statfacts/html/colorect.
html access date 28.06.2016
- 4. Nasiri S, Donboli K, Meysamie A, et al. Prognostic factors
in survival of colorectal cancer patients after surgery.
Colorectal Disease 2008;11:157-61.
- 5. Moghimi-Dehkordi B, Safaee A, Zali MR. Prognostic factors
in 1,138 Iranian colorectal cancer patients. Int J Colorectal
Dis 2008;23:683-8.
- 6. Ragg JL, Watters DA, Guest GD. Preoperative risk
stratiication for mortality and major morbidity in major
colorectal surgery. Dis Colon Rectum 2009;52:1296-303
- 7. Gallina S, Proposito D, Veltri S, et al. Colorectal cancer
surgery. Analysis of risk factors in relation to incidence of
morbidity and mortality. Chir Ital 2006;58:723-32.
- 8. Carpelan-Holmström M, Louhimo J, Stenman UH, et al.
Estimating the probability of cancer with several tumor
markers in patients with colorectal disease. Oncology
2004;66:296-302.
- 9. Locker GY, Hamilton S, Harris J, et al. ASCO 2006 update
of recommendations for the use of tumor markers in
gastrointestinal cancer. J Clin Oncol 2006;24:5313-27.
- 10. Andreola S, Leo E, Belli F, et al. Manual dissection of
adenocarcinoma of the lower third of the rectum specimens
for detection of lymph node metastases smaller than 5 mm.
Cancer 1996;77:607-12.
- 11. Park YJ, Park KJ, Park JG, et al. Prognostic factors in 2230
Korean colorectal cancer patients: analysis of consecutively
operated cases. World J Surg 1999;23:721-26.
- 12. National Comprehensive Cancer Network (NCCN)
recommendations available online at http: //www.nccn.org/
professionals/physician_gls/f_guidelines.asp access date
15.12.2018
- 13. Brown G, Richards CJ, Bourne MW, et al. Morphologic
predictors of lymph node status in rectal cancer with use
of high-spatial-resolution mr ımaging with histopathologic
comparison. Radiology 2003;227:371-77.
- 14. Meyenberger C, HuchBöni RA, Bertschinger P, et al.
Endoscopic ultrasound and endorectal magnetic resonance
imaging: a prospective, comparative study for preoperative
staging and follow-up of rectal cancer. Endoscopy
1995;27:469-79.
- 15. Valentini V, Glimelius B, Minsky BD. The multidisciplinary
rectal cancer treatment: main convergences, controversial
aspects and investigational areas which support the need
for an european consensus. Radiother Oncol 2005;76:241-
50.
- 16. Madoff RD. Chemoradiotherapy for rectal cancer? When,
why and how? N Engl J Med 2004;351:1790-92.
- 17. Berardi R, Maccaroni E, Onofri A, et al. Multidisciplinary
treatment of locally advanced rectal cancer: A literature
review. Expert Opin Pharmacoter 2009;10:1-14.
- 18. Willett CG, Lewandrowski K, Donnelly S, et al. Are there
patients with stage I rectal carcinoma at risk for failure after
abdominoperineal resection? Cancer 1992;69:1651-55.
- 19. den Dulk M, Marijnen CA, Putter H, et al. Risk Factors for
Adverse Outcome in Patients With Rectal Cancer Treated
With an Abdominoperineal Excision in the Total Mesorectal
Excision Trial. Ann Surg 2007;246: 83-90.
- 20. Jeong SY, Park JW, Nam BH, et al. Open versus laparoscopic
surgery for mid-rectal or low-rectal cancer after neoadjuvant
chemoradiotherapy (COREAN trial): survival outcomes of
an open-label, non-inferiority, randomised controlled trial.
Lancet Oncol 2014;15:767-74.
- 21. Bonjer HJ, Deijen CL, Abis GA, et al.; COLOR II Study Group.
A randomized trial of laparoscopic versus open surgery for
rectal cancer.NEngl J Med 2015;372:1324-32.
- 22. Stevenson AR, Solomon MJ, Lumley JW, et al. Effect of
laparoscopic-assisted resection vs open resection on
pathological outcomes in rectal cancer: the aLaCaRT
randomized clinical trial. JAMA 2015;314:1356-63.
- 23. Fleshman J, Branda M, Sargent DJ, et al. Effect of
laparoscopic-assisted resection vs open resection of stage
iI or III rectal cancer on pathologic outcomes: the ACOSOG
Z6051 randomized clinical trial. JAMA 2015;314:1346-55.
- 24. Leung KL, Kwok SP, Lam SC. Laparoscopic resection of
rectosigmoid carcinoma: Prospective randomised trial.
Lancet 2004;363:1187-92.
- 25. Gao F, Cao YF, Chen LS. Meta-analysis of short-term
outcomes after laparoscopic resection for rectal cancer. Int
J Colorectal Dis 2006;21:652-56.
- 26. Alvarez JA, Baldonedo RF, Bear IG, et al. Presentation,
treatment, and multivariate analysis of risk factors for
obstructive and perforative colorectal carcinoma. Am J Surg
2005;190:376.
- 27. Compton CC, Fielding LP, Burgart LJ, et al. Prognostic
factors in colorectal cancer: College of American
pathologists consensus statement 1999. Arch Pathol Lab
Med 2000;124:979-94.
- 28. Tepper JE, O’Connell MJ, Niedzwiecki D, et al. Impact of
number of nodes retrieved on outcome in patients with
rectal cancer. J Clin Oncol 2001;19:157-63.
- 29. Chang GJ, Rodriguez-Bigas MA, Skibber JM, et al. Lymph
node evaluation and survival after curative resection of colon
cancer: systematic review. J Natl Cancer Inst 2007;99:433-
41.
- 30. Ferenschild FT, Dawson I, de Wilt JH, et al. Total mesorectal
excision for rectal cancer in an unselected population:
quality assessment in a low volume center. Int J Colorectal
Dis 2009;24:923-29.
- 31. Liebig C, Ayala G, Wilks J, et al. Perineural invasion is an
independent predictor of outcome in colorectal cancer. J
Clin Oncol 2009;27:5131-37.
- 32. Lim SB, Yu CS, Jang SJ, et al. Prognostic significance of
lymphovascular invasion in sporadic colorectal cancer. Dis
Colon Rectum 2010;53:377-84.
- 33. Wolmark N, Fisher B. An analysis of survival and treatment
failure following abdominoperineal and sphincter-saving
resection in Dukes’ B and C rectal carcinoma. A report of the
NSABP clinical trials. National Surgical Adjuvant Breast and
Bowel Project. Ann Surg 1986;204:480-9.
- 34. Vernava AM, 3rd, Moran, M, Rothenberger, DA, et al. A
prospective evaluation of distal margins in carcinoma of the
rectum. Surg Gynecol Obstet 1992;175:333-37.
- 35. Williams, NS, Dixon, MF, Johnson, D. Reappraisal of the
5 centimetre rule of distal excision for carcinoma of the
rectum; a study of distal intramural spread and of patients’
survival. Br J Surg 1983;70:150-4.
- 36. Macadam R, Yeomans N, Wilson J, et al. Factors af-fecting
morbidity, mortality and survival in patients undergoing
surgery for rectal cancer in a district general hospital. Ann R
Coll Surg Engl 2005;87:334-8.
- 37. Cerottini JP, Caplin S, Pampallona S, et al. Prognostic factors
in colorectal cancer. Oncol Rep 1999;6:409-14.
- 38. Davila JA, Rabeneck L, Berger DH. Postoperative 30-day
mortality following surgical resection for colorectal cancer
in veterans: changes in the right direction. Dig Dis Sci
2005;50:1722-28.