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Oncological outcome following Hartmann's procedure compared with anterior resection and abdominoperineal resection for rectal cancer-The type of procedure does not influence local recurrence or distant metastasis: A population-based study.
Mariusdottir, Elin; Jörgren, Fredrik; Lydrup, Marie-Louise; Buchwald, Pamela.
Afiliación
  • Mariusdottir E; Department of Surgery, Helsingborg Hospital, Helsingborg, Lund University, Lund, Sweden.
  • Jörgren F; Department of Surgery, Helsingborg Hospital, Helsingborg, Lund University, Lund, Sweden.
  • Lydrup ML; Department of Surgery, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
  • Buchwald P; Department of Surgery, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
Colorectal Dis ; 2024 Sep 08.
Article en En | MEDLINE | ID: mdl-39245864
ABSTRACT

AIM:

The type of surgical procedure used in rectal cancer treatment may affect cancer recurrence. The aim of this study was to determine whether the type of procedure influences oncological outcomes in rectal cancer surgery.

METHOD:

We gathered data from the Swedish Colorectal Cancer Registry regarding patients with TNM Stage I-III rectal cancer who underwent R0/R1 surgery from 2013 to 2017. The outcomes after Hartmann's procedure (HP), anterior resection (AR) and abdominoperineal resection (APR) were compared, and a multivariable Cox regression analysis was performed. The primary outcome of the study was the local recurrence rate. The secondary outcomes were distant metastasis, disease-free survival and overall survival at 5 years as well as risk factors for local recurrence.

RESULTS:

A total of 4741 patients were included in the study 614 underwent HP, 3075 underwent AR and 1052 underwent APR. Multivariable Cox regression revealed no difference in local recurrence, distant metastasis or disease-free survival. Overall survival was higher following AR (OR 0.62, CI 0.54-0.72). Risk factors for local recurrence were intraoperative bowel perforation (OR 2.41, CI 1.33-4.40), a pT4 tumour (OR 1.93, CI 1.11-3.4) and a positive circumferential resection margin (OR 5.62, CI 3.28-9.61).

CONCLUSIONS:

This nationwide study showed that the type of procedure did not affect the local recurrence rate or distant metastasis. In patients who are unfit for restorative surgery, HP is a viable alternative with oncological outcomes similar to those of APR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido