Oncologic Outcome of Intersphincteric Resection for Very Low Rectal Cancer
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In 2000 we launched a prospective program of intersphincteric resection (ISR) for very low rectal cancer. In this study we compared the oncologic outcome of patients who underwent ISR with the outcome of patients who underwent abdominoperineal resection (APR).
The data of 202 patients with very low rectal cancer who underwent curative ISR (n = 132) or curative APR (n = 70) between 1995 and 2006 were analyzed. Patients were divided into ISR and APR groups. Survival and local recurrence were investigated in both groups.
The median follow-up was 40 months in the ISR group and 57 months in the APR group. The 5-year local relapse-free survival rate was 83% in the ISR group and 80% in the APR group (p = 0.364), and the 5-year disease-free survival rate was 69% in the ISR group and 63% in the APR group (p = 0.714).
For very low rectal cancers, ISR appears to be oncologically acceptable and can reduce the number of APRs.
KeywordsRectal Cancer Total Mesorectal Excision Local Recurrence Rate Anal Verge Coloanal Anastomosis
This study was supported in part by a Grant-in-Aid (18-7) for Cancer Research from the Ministry of Health, Labour and Welfare of Japan. We thank the staff of the Department of Pathology at our institute for the pathologic investigations performed for the present study.
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