Surgical outcome after standard abdominoperineal resection: A 15-year cohort study from a single cancer centre

S. Wilkins, R. Yap, K. Loon, M. Staples, K. Oliva, B. Ruggiero, P. McMurrick, P. Carne

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Abdominoperineal resection (APR) is associated with a poorer oncological outcome than anterior resection. This may be due to higher rates of intra-operative perforation and circumferential resection margin involvement. The aim of this study was to audit our short and long-term results of abdominoperineal resection performed using conventional techniques and to compare this with other published series. Materials and methods: A retrospective review of all patients who had standard APR between January 2000 and December 2016 in a single institution, Cabrini Hospital, Melbourne, Australia. A total of 163 cases performed by nine different colorectal surgeons for primary rectal adenocarcinoma were identified, with their clinicopathological data analysed. Results: Using standard APR, only six patients (3.7%) were found to have a positive circumferential resection margin (CRM). There were two cases of intra-operative perforation (1.2%). Local recurrence rate was 5.6% of patients, with distant recurrence found in 24.9%. Disease-free survival at five years was 73.1%. Five-year overall survival was 66.7%, 67.9% of all deaths were cancer-related. Conclusion: Short and long-term outcomes after standard APR in this study were comparable to previous published studies. The CRM rate of 3.7% compares favourably to published positive CRM rates for standard APR which ranged from 6 to 18%. Standard APR remains a viable technique for the treatment of rectal cancer. Patient selection and adequate training remain important factors.

Original languageEnglish
Pages (from-to)83-89
Number of pages7
JournalAnnals of Medicine and Surgery
Volume36
DOIs
Publication statusPublished - 1 Dec 2018

Keywords

  • Abdominoperineal
  • Colorectal
  • Outcomes
  • Surgery

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