Bozzetti F, Mariani L, Miceli R, Doci R, Montalto F, Andreola S, Gennari L
Division of Surgery of the Digestive Tract, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
J Surg Oncol. 1996 Jul;62(3):207-13. doi: 10.1002/(SICI)1096-9098(199607)62:3<207::AID-JSO11>3.0.CO;2-3.
The purpose of this study was to compare local recurrence, distant metastases, and survival rate in 350 patients with cancer of the middle and low rectum who underwent a radical abdominoperineal resection (APER) or a sphincter-saving resection (SSR) in our Institute. There were 257 APER patients and 93 SSR patients, with a median follow-up of 77 months. At 5 years, the estimates in APER and SSR patients were respectively 11% and 30% for the incidence of pelvic recurrence, 18% and 8% for the incidence of distant metastases, and 64% and 73% for overall survival. In the multivariate analysis it was found that Dukes' stage significantly affected pelvic recurrences, distant metastases rate and overall survival; histologic type affected only the pelvic recurrence rate. However, the final outcome of patients following APER or SSR was similar, suggesting that local failure per se does not affect long-term survival.
