Bhangu, A., Rasheed, S., Brown, G., Tait, D., Cunningham, D., Tekkis, P. (2014) Does rectal cancer height influence the oncological outcome? COLORECTAL DISEASE, 16 (10). pp. 801-808. ISSN 1462-8910

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Abstract

AimThe influence of the height of rectal cancer from the anal verge on the oncological outcome is controversial. This study aimed to determine the influence of the height of the tumour on the survival of patients treated in a specialized rectal cancer unit. MethodPatients undergoing surgery for primary rectal cancer from 2006 to 2013 were identified from a prospectively maintained rectal cancer database. Those requiring total or multicompartmental pelvic exenteration were excluded. Low cancer was defined as tumour <5cm from the anal verge, as assessed by endoscopy and/or digital rectal examination. The primary outcome was 3-year disease-free survival (DFS). ResultsOf 340 patients, 203 (59.7%) had low cancer. There were 302 (89%) restorative and 38 (11%) nonrestorative procedures. The rate of positive circumferential resection margin was similar for low compared with high cancer (3.4% vs 2.9%, P=1.0) and for restorative compared with nonrestorative procedures in low cancer only (3.0% and 5.3%, P=0.619). Low compared with high anterior resection was associated with increased anastomotic leakage (8.5% vs 2.2%, P=0.023). Three-year DFS was similar for low and high resection (82% vs 86%, P=0.305) and between restorative vs nonrestorative procedures in low cancer only (88% vs 77%, P=0.215). In an adjusted model, low height did not lead to worse survival outcome (3-year DFS hazard ratio 0.54, 95% CI 0.24-1.24, P=0.147). ConclusionWith careful planning and a multidisciplinary approach, equivalent oncological outcome can be achieved for patients with rectal cancer who undergo curative surgery regardless of differences in tumour characteristics, location and operation performed.

Item Type:	Article
Authors (ICR Faculty only):	Cunningham, David and Brown, Gina
All Authors:	Bhangu, A., Rasheed, S., Brown, G., Tait, D., Cunningham, D., Tekkis, P.
Additional Information:	ISI Document Delivery No.: AP8PS Times Cited: 0 Cited Reference Count: 23 Bhangu, A. Rasheed, S. Brown, G. Tait, D. Cunningham, D. Tekkis, P. Imperial College Cancer Research UK centre; Royal Marsden Biomedical Research Centre Thanks to Alistair Slesser and Manish Chand for assistance with data collection. The present study is funded by the Imperial College Cancer Research UK centre and the Royal Marsden Biomedical Research Centre. 0 WILEY-BLACKWELL HOBOKEN COLORECTAL DIS
Uncontrolled Keywords:	Rectal cancer low rectal cancer abdominoperineal excision anterior resection TOTAL MESORECTAL EXCISION EXTRALEVATOR ABDOMINOPERINEAL EXCISION LOCALLY ADVANCED PRIMARY ANTERIOR RESECTION SURGERY RATES EXPERIENCE SURVIVAL
Research teams:	Clinical Units > Department of Diagnostic Radiology Clinical Units > Gastrointestinal Unit
Depositing User:	Barry Jenkins
Date Deposited:	23 Oct 2014 03:52
Last Modified:	23 Oct 2014 03:52
URI:	http://publications.icr.ac.uk/id/eprint/13655

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