Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer

Introduction: Abdomino-perineal resection has been the standard treatment for rectal tumors located ⩽5 cm from the anal verge. Recently, intersphincteric resection became a valid option which preserves the bowel continuity with better functional outcome. Aim: Is to evaluate the oncological and funct...

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Main Authors: W. Abdel-Gawad, A. Zaghloul, I. Fakhr, M. Sakr, A. Shabana, M. Lotayef, O. Mansour
Format: Article
Language:English
Published: SpringerOpen 2014-06-01
Series:Journal of the Egyptian National Cancer Institute
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110036214000053
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spelling doaj-ba0a82096d63453fb962c9dd82a298362020-11-25T01:36:07ZengSpringerOpenJournal of the Egyptian National Cancer Institute1110-03622014-06-01262879210.1016/j.jnci.2014.02.001Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancerW. Abdel-Gawad0A. Zaghloul1I. Fakhr2M. Sakr3A. Shabana4M. Lotayef5O. Mansour6Surgical Oncology Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptSurgical Oncology Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptSurgical Oncology Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptSurgical Pathology Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptRadio-Diagnosis Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptRadiation Oncology Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptMedical Oncology Department, National Cancer Institute (NCI), Fom-El-Khalig, Cairo, EgyptIntroduction: Abdomino-perineal resection has been the standard treatment for rectal tumors located ⩽5 cm from the anal verge. Recently, intersphincteric resection became a valid option which preserves the bowel continuity with better functional outcome. Aim: Is to evaluate the oncological and functional outcome alongside the associated surgical morbidity in patients with T1-3 rectal cancer, who underwent intersphincteric resection (ISR). Patients & methods: Between the years 2006 and 2011, 55 patients with invasive rectal adenocarcinoma, T1-3 lesions, located 2–5 cm from the anal verge underwent ISR with total mesorectal excision. When inevitable, complete. ISR was performed, otherwise partial ISR was done. All T3 patients underwent total meso-rectal excision (TME) while some had lateral lymph node dissection (LND) with concomitant pelvic autonomic nerve preservation (PANP). Results: Among the 55 patients, 21 (38.1%) patients were T1-2 and 34 (61.9%) patients were T3. The tumor location range was 0–5 cm from the anal verge (median 2.3 cm). Partial or complete ISR was done for 35 (63.6%) and 20 (36.4%), respectively. Patients were followed for a median of 1.5 years (range 1–4.6 years). The 3 year local recurrence and distant metastasis free rates were 85.2% and 85.6%, respectively. All the 3 local recurrences occurred in T3 patients group, and had positive circumferential resection margins. Overall 3-year disease-free survival was 82.6%; while the overall 3-year survival was 88.7%. Conclusion: Intersphincteric resection with TME does not affect the local recurrence or overall survival rate in early rectal cancer T1-2 & 3, with preservation of bowel continuity and better life quality.http://www.sciencedirect.com/science/article/pii/S1110036214000053Intersphincteric resectionLocal recurrenceLow rectal cancer
collection DOAJ
language English
format Article
sources DOAJ
author W. Abdel-Gawad
A. Zaghloul
I. Fakhr
M. Sakr
A. Shabana
M. Lotayef
O. Mansour
spellingShingle W. Abdel-Gawad
A. Zaghloul
I. Fakhr
M. Sakr
A. Shabana
M. Lotayef
O. Mansour
Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
Journal of the Egyptian National Cancer Institute
Intersphincteric resection
Local recurrence
Low rectal cancer
author_facet W. Abdel-Gawad
A. Zaghloul
I. Fakhr
M. Sakr
A. Shabana
M. Lotayef
O. Mansour
author_sort W. Abdel-Gawad
title Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
title_short Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
title_full Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
title_fullStr Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
title_full_unstemmed Evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
title_sort evaluation of the frequency and pattern of local recurrence following intersphincteric resection for ultra-low rectal cancer
publisher SpringerOpen
series Journal of the Egyptian National Cancer Institute
issn 1110-0362
publishDate 2014-06-01
description Introduction: Abdomino-perineal resection has been the standard treatment for rectal tumors located ⩽5 cm from the anal verge. Recently, intersphincteric resection became a valid option which preserves the bowel continuity with better functional outcome. Aim: Is to evaluate the oncological and functional outcome alongside the associated surgical morbidity in patients with T1-3 rectal cancer, who underwent intersphincteric resection (ISR). Patients & methods: Between the years 2006 and 2011, 55 patients with invasive rectal adenocarcinoma, T1-3 lesions, located 2–5 cm from the anal verge underwent ISR with total mesorectal excision. When inevitable, complete. ISR was performed, otherwise partial ISR was done. All T3 patients underwent total meso-rectal excision (TME) while some had lateral lymph node dissection (LND) with concomitant pelvic autonomic nerve preservation (PANP). Results: Among the 55 patients, 21 (38.1%) patients were T1-2 and 34 (61.9%) patients were T3. The tumor location range was 0–5 cm from the anal verge (median 2.3 cm). Partial or complete ISR was done for 35 (63.6%) and 20 (36.4%), respectively. Patients were followed for a median of 1.5 years (range 1–4.6 years). The 3 year local recurrence and distant metastasis free rates were 85.2% and 85.6%, respectively. All the 3 local recurrences occurred in T3 patients group, and had positive circumferential resection margins. Overall 3-year disease-free survival was 82.6%; while the overall 3-year survival was 88.7%. Conclusion: Intersphincteric resection with TME does not affect the local recurrence or overall survival rate in early rectal cancer T1-2 & 3, with preservation of bowel continuity and better life quality.
topic Intersphincteric resection
Local recurrence
Low rectal cancer
url http://www.sciencedirect.com/science/article/pii/S1110036214000053
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