scholarly journals Comparison of oncologic outcome of abdominoperineal resection versus sphincter saving resection for low lying rectal cancer

2021 ◽  
Vol 17 (2) ◽  
pp. 73-81
Author(s):  
Won Il Jo ◽  
Dae Ro Lim ◽  
Jung Cheol Kuk ◽  
Eung Jin Shin
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Recurrence Rate ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Positive Lymph Node ◽  
Oncological Outcomes ◽  
Sphincter Saving Resection ◽  
Sphincter Saving

Purpose: The present study compares the peri/postoperative and oncological outcomes of abdominoperineal resections (APR) and sphincter saving resection (SSR) for low lying rectal cancer.Methods: Between January 2001 and December 2014, 176 patients who underwent SSR (n = 67) and APR (n = 109) for low rectal cancer, without stage IV, were retrieved from a retrospective database.Results: With a median follow-up of 66.5 months. The mean total number of harvested lymph nodes was 16.7 (SSR) versus 17.1 (APR) (P = 0.801). The advanced T stage was higher in the APR group (82.6%) versus the SSR group (55.2%) (P = 0.006). The positive rate of lymph nodes after surgery was significantly higher in the APR group (45.9%) versus SSR group (25.4%) (P < 0.05). The 5-year overall survival rates for SSR and APR were 87.3% and 67.6%, respectively (P < 0.005). The 5-year disease-free survival rate (DFS) was 83.6% (SSR) versus 65.5% (APR) (P = 0.002). The recurrence rate was higher in the APR group (34.9%) versus the SSR group (14.9%) (P = 0.004). Local recurrence rate was not different between the two groups. However, distant recurrence rate was significantly higher in the APR group (26.6% vs. 11.9%, P = 0.023). In multivariate analysis, node positive (N0 vs. N1-2) was an independent prognostic factor for DFS (P < 0.005).Conclusion: Based on the present data, SSR achieved better 5-year oncological outcome than APR. The positive lymph node ratio in the N stage after surgery was higher in the APR group and this seems to have an effect on the oncological outcomes of the APR group.

Oncological strategy following R1 sphincter-saving resection in low rectal cancer after chemoradiotherapy

2021 ◽  
Author(s):  
Quentin Denost ◽  
Vincent Assenat ◽  
Veronique Vendrely ◽  
Bertrand Celerier ◽  
Anne Rullier ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Low Rectal Cancer ◽  
Sphincter Saving Resection ◽  
Sphincter Saving

scholarly journals Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer

2020 ◽  
Vol 24 (10) ◽  
pp. 1025-1034 ◽  
Author(s):  
G. Sun ◽  
Z. Lou ◽  
H. Zhang ◽  
G. Y. Yu ◽  
K. Zheng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Rectal Wall ◽  
Anal Verge ◽  
Disease Free Survival ◽  
Sphincter Preservation ◽  
Low Rectal Cancer ◽  
Anal Function ◽  
Oncological Outcomes ◽  
Rectal Cancers ◽  
Very Low Rectal Cancer

Abstract Background Conformal sphincter preservation operation (CSPO) is a new surgical procedure for very low rectal cancers (within 4–5 cm from the anal verge). CSPO preserves more of the dentate line and distal rectal wall and also avoids injuring nerves in the intersphincteric space, resulting in satisfactory anal function after resection. The aim of this study was to analyze the short-term surgical results and long-term oncological and functional outcomes of CSPO. Methods Consecutive patients with very low rectal cancer, who had CSPO between January 2011 and October 2018 at Changhai Hospital, Shanghai were included. Patient demographics, clinicopathological features, oncological outcomes and anal function were analyzed. Results A total of 102 patients (67 men) with a mean age of 56.9 ± 10.8 years were included. The median distance of the tumor from the anal verge was 3 (IQR, 3–4) cm. Thirty-five patients received neoadjuvant chemoradiation (nCRT). The median distal resection margin (DRM) was 0.5 (IQR, 0.3–0.8) cm. One patient had a positive DRM. All circumferential margins were negative. There was no perioperative mortality. The postoperative complication rate was 19.6%. The median duration of follow-up was 28 (IQR, 12–45.5) months. The local recurrence rate was 2% and distant metastasis rate was 10.8%. The 3-year overall survival and disease-free survival rates were 100% and 83.9%, respectively. The mean Wexner incontinence and low anterior resection syndrome scores 12 months after ileostomy reversal were 5.9 ± 4.3, and 29.2 ± 6.9, respectively. Conclusions For patients with very low rectal cancers, fecal continence can be preserved with CSPO without compromising oncological results.

Phẫu thuật bảo tồn hậu môn điều trị ung thư trực tràng thấp tại Bệnh Viện Ung Bướu TPHCM

2020 ◽  
Author(s):  
Cuong Pham Hung
Keyword(s):  
Rectal Cancer ◽  
Rectal Carcinoma ◽  
Early Stage ◽  
Anal Verge ◽  
Low Rectal Cancer ◽  
Resection Rate ◽  
Sphincter Saving Resection ◽  
Sphincter Saving ◽  
Surgery Department ◽  
Significant Increment

Purpose: To analyse changes in performing sphincter-saving resection procedures for low rectal cancer in HCMC Oncology Hospital in the last 15 years (2004-2019). Patients and Methods: Medical records of 17 cases of low rectal carcinoma operated on from January through Juin, 2019 in Surgery Department No 2, HCMC Oncology Hospital were studied retrospectively. Data were compared to that of cases of low rectal carcinoma also operated on in HCMC Oncology Hospital from January, 2000 through December, 2004 (2004 group). Results: Compared with 2004 group, the sphincter-saving resection rate significantly increased (53% vs 4%, p<0.001); although there were higher proportions of men (77% vs 36%, p=0.003) and of early stage patients (29% stage I vs 4%, p<0.001). Sphincter-saving resection procedures were performed for 53% low rectal cancer patients (95% CI: 28-77%). All patients with tumors more than 3cm from the anal verge were operated on with sphincter-saving resection procedures. Conclusion: There was a significant increment of sphincter-saving resection for low rectal cancer in HCMC Oncology Hospital in the last 15 years (2004-2019). It was not different from worldwide trends.

Wilm's tumor with pulmonary metastases at diagnosis: the significance of primary chemotherapy. International Society of Pediatric Oncology Nephroblastoma Trial and Study Committee.

1990 ◽  
Vol 8 (7) ◽  
pp. 1187-1190 ◽  
Author(s):  
J de Kraker ◽  
J Lemerle ◽  
P A Voûte ◽  
J M Zucker ◽  
M F Tournade ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Wilms Tumor ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Local Therapy ◽  
Stage Iv ◽  
Actuarial Survival ◽  
Preoperative Ct ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

Data from patients with pulmonary metastases (PM) from Wilms' tumor at diagnosis (stage IV) were collected from six European centers. All patients were pretreated with a chemotherapy (CT) regimen consisting of vincristine (VCR), dactinomycin (AD), and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH). After nephrectomy, local therapy for residual pulmonary disease was considered to avoid whole-lung irradiation. Only four of 36 patients still had multiple inoperable metastases after preoperative CT. Thirty patients survived. Four of them were irradiated. Of the six patients who died, four died of PM, one died of abdominal recurrence, and one of therapy-related disease. Disease-free survival and actuarial survival rates are 83% with a mean follow-up of 4 years postnephrectomy.

scholarly journals Comparison of Minimally Invasive versus Open Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: A Propensity Score Matching Analysis

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 982 ◽  
Author(s):  
Jaewoo Kwon ◽  
Ki Byung Song ◽  
Seo Young Park ◽  
Dakyum Shin ◽  
Sarang Hong ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Ductal Adenocarcinoma ◽  
Propensity Score Matching Analysis ◽  
Oncological Outcomes ◽  
Hospital Stays

Background: Few studies have compared perioperative and oncological outcomes between minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) for pancreatic ductal adenocarcinoma (PDAC). Methods: A retrospective review of patients undergoing MIPD and OPD for PDAC from January 2011 to December 2017 was performed. Perioperative, oncological, and survival outcomes were analyzed before and after propensity score matching (PSM). Results: Data from 1048 patients were evaluated (76 MIPD, 972 OPD). After PSM, 73 patients undergoing MIPD were matched with 219 patients undergoing OPD. Operation times were longer for MIPD than OPD (392 vs. 327 min, p < 0.001). Postoperative hospital stays were shorter for MIPD patients than OPD patients (12.4 vs. 14.2 days, p = 0.040). The rate of overall complications and postoperative pancreatic fistula did not differ between the two groups. Adjuvant treatment rates were higher following MIPD (80.8% vs. 59.8%, p = 0.002). With the exception of perineural invasion, no differences were seen between the two groups in pathological outcomes. The median overall survival and disease-free survival rates did not differ between the groups. Conclusions: MIPD showed shorter postoperative hospital stays and comparable perioperative and oncological outcomes to OPD for selected PDAC patients. Future randomized studies will be required to validate these findings.

A phase II study of gemcitabine, ifosfamide, and oxaliplatin (GIFOX) as upfront treatment for high-risk, non-anaplastic large cell, peripheral T-cell lymphomas.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8564-8564
Author(s):  
Gaetano Corazzelli ◽  
Gianpaolo Marcacci ◽  
Ferdinando Frigeri ◽  
Gaetana Capobianco ◽  
Francesco Volzone ◽  
...  
Keyword(s):  
T Cell ◽  
High Risk ◽  
Nk Cell ◽  
Autologous Transplantation ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Early Death ◽  
Free Survival ◽  
Safe Delivery

8564 Background: Patients (pts) with peripheral T/NK cell lymphomas (PTCL) and intermediate-high/high IPI risk have a 5-yr overall survival < 20%. Current chemotherapy is unsatisfactory while benefit of upfront autologous transplantation (ASCT) is limited by high pre-transplant progression rates and pts advanced age. We evaluated efficacy and stem cells (SCs)-mobilizing activity of a biweekly regimen of gemcitabine (G), ifosfamide (Ifo) and oxaliplatin (Ox) (GIFOX), as an upfront strategy ensuring fast cytoreduction and early ASCT access or an effective alternative to CHOP-like programs in transplant-inelegible pts. Methods: Six biweekly courses of GIFOX [G 1000 mg/m2 D1, Ox 130 mg/m2 D2, Ifo 5 g/m2 D2 as 24h infusion (fractionated over days 2-4 in pts>65 yrs), G-CSF DD 7-11] were planned for all pts, with SCs mobilization at course 3 in ASCT-eligible pts. Simon's minimax two-stage design was adopted with the primary and secondary endpoints of response rate (RR) and progression-free survival (PFS), respectively. Results: Thirty-four pts (median age 63 yrs, r 42-80) [PTCL, nos (n=16), AITL (n=7), extranodal NK/T-cell (n=5), SS (n=6)], with IPI score intermediate-high (62%) or high (38%) were accrued [stage IV: 71%; BM involvement: 38%; E-site >1: 47%; hi LDH: 71%; ECOG>1: 38%; B-symptoms: 44%]. A total of 172 courses was delivered (median 6, r 2-6). Only 5 pts received <4 courses, due to progression (n=4) or early death (n=1). Overall RR was 82% [95% CI, 66-92; 22 complete (CR) and 6 partial (PR) responses]. Twelve pts mobilized SCs (median CD34+ cells harvest: 4.36x106/kg) and 8 (7CRs,1PR) underwent ASCT, 6 to 13 weeks after the 6th course. Estimated 5-yr PFS was 48% (95%CI: 28-65); median PFS for non-transplanted pts was 15 mo.s. Estimated 4-yr disease-free survival was 58%. Relevant toxicities were G4 thrombocytopenia (13%), G4 anemia (23%), G3/G4 infection (29%/6%), G3 encephalopathy (6%). Conclusions: Response and survival rates of GIFOX in high-risk PTCL compared more than favorably to CHOP-based regimens. Effective cytoreduction and prompt access to ASCT were ensured, together with safe delivery of a full induction program to transplant-ineligible pts.

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