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

Cite this

@article{a7fa74817d304326a01542149eaf71f0,
title = "Surgical outcome after standard abdominoperineal resection: A 15-year cohort study from a single cancer centre",
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.",
keywords = "Abdominoperineal, Colorectal, Outcomes, Surgery",
author = "S. Wilkins and R. Yap and K. Loon and M. Staples and K. Oliva and B. Ruggiero and P. McMurrick and P. Carne",
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Surgical outcome after standard abdominoperineal resection : A 15-year cohort study from a single cancer centre. / Wilkins, S.; Yap, R.; Loon, K.; Staples, M.; Oliva, K.; Ruggiero, B.; McMurrick, P.; Carne, P.

In: Annals of Medicine and Surgery, Vol. 36, 01.12.2018, p. 83-89.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Surgical outcome after standard abdominoperineal resection

T2 - A 15-year cohort study from a single cancer centre

AU - Wilkins, S.

AU - Yap, R.

AU - Loon, K.

AU - Staples, M.

AU - Oliva, K.

AU - Ruggiero, B.

AU - McMurrick, P.

AU - Carne, P.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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.

AB - 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.

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KW - Colorectal

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KW - Surgery

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M3 - Article

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EP - 89

JO - Annals of Medicine and Surgery

JF - Annals of Medicine and Surgery

SN - 2049-0801

ER -