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Gender aspects of survival after abdominoperineal resection for low rectal cancer: a retrospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The difference in prognosis between genders after abdominoperineal resection (APR) for low rectal cancer (LRC) is unclear. This study aimed to compare survival outcomes between genders in patients with LRC who underwent curative APR.

Methods

This retrospective cohort study used a database of consecutive colorectal resections. Patients who received curative APR with LRC were grouped according to their gender. Female patients were frequency-matched 1:1 on American Joint Committee on Cancer (AJCC) stage to male patients. Overall survival (OS), disease-free survival (DFS), and their independent risk factors were examined.

Results

A total of 140 patients with APR for LRC were included after matching: 70 (50.0%) males and 70 (50.0%) females. No significant differences were found between the groups in terms of age, operation methods, AJCC stage, and adjuvant therapy (all P > 0.05). Median follow-up was 39 (range: 3–128) months. Male gender was independently associated with worse OS (adjusted hazard ratio [HR] = 2.755, 95% CI: 1.507–5.038, P = 0.001) and worse DFS (adjusted HR = 2.440, 95% CI: 1.254–4.746, P = 0.009). Subgroup analysis revealed that female patients with stage III disease had better OS (P = 0.001) and DFS (P < 0.001) than male patients.

Conclusion

Gender affects survival after a curative APR for LRC. Compared with females, male patients with LRC after curative APR had worse prognosis, especially for stage III disease.

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Data availability

The data set supporting the results of this article are included within the article.

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Funding

This work was supported by the research project of the Sichuan Medical Association and the Health Commission of Sichuan Province of China (No. 20PJYY1734).

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Author notes

  1. Feng Bao and Jianying Shang contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Mianyang Central Hospital, 12 Changjia Lane, Jingzhong Street, Mianyang, 621000, Sichuan, China

    Feng Bao, Jianying Shang, Chunhua Xiang, Guoqiang Li, Xing Zhi, Wen Liu, Dong Wang, Jianbo Xian-Yu & Zhigang Deng

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  1. Feng Bao
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Contributions

BF and DZG conceived and supervised the study; DZG designed experiments; XCH and LGQ performed experiments; ZX and LW analyzed data; BF and SJY wrote the manuscript; WD and XYJB made manuscript revisions. All authors reviewed the results and approved the final version of the manuscript.

Corresponding author

Correspondence to Zhigang Deng.

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The authors declare that they have no conflict of interest.

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This retrospective study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Mianyang Central Hospital approved this study.

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Bao, F., Shang, J., Xiang, C. et al. Gender aspects of survival after abdominoperineal resection for low rectal cancer: a retrospective study. Int J Colorectal Dis 35, 2001–2010 (2020). https://doi.org/10.1007/s00384-020-03671-2

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