Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer
Division of Colorectal Surgery, Department of General Surgery, Uludağ University Faculty of Medicine, Bursa, Türkiye
Objective: In our study, it was aimed to evaluate the factors affecting oncological outcomes in resections for rectal cancer.
Material and Methods: Between January 2010 and December 2014, patients with rectal tumors were analyzed retrospectively. Demographic and pathological data and oncological outcomes were analyzed as disease-free survival, overall survival, and local recurrence.
Results: A total of 158 patients’ data were obtained. Median age was 60 (22-83). Fifty-three patients were older than 65 years of age (138). Ninety-five (60%) patients were males, and 63 (40%) were females. Eighty patients (50.4%) had middle rectal, and 78 (49.6) patients had lower rectal cancer. There was no effect of tumor localization on oncological outcomes. Univariate analyses revealed the effects of age (p= 0.003), operation type (p< 0.001), nodal status (p< 0.001), malignant lymph node ratio (p< 0.001), stage of the disease (p< 0.001), distal resection margin (p= 0.047), perineural invasion (p< 0.001), lymphatic invasion (p< 0.001), venous-vascular invasion (p= 0.025), local recurrence (p< 0.001) and distant metastasis (p< 0.001) on overall survival rates. Univariate analyses revealed the effects of nodal status (p= 0.007), malignant lymph node ratio (p= 0.005), stage of the disease (p= 0.008), perineural invasion (p= 0.004) and venous-vascular invasion (p< 0.001) on disease-free survival rates. Univariate analyses revealed the effects of anastomotic leak (p= 0.015) and venous-vascular invasion (p= 0.001) on local recurrence rates.
Conclusion: Older age, advanced nodal status, and distant metastasis were detected as independent risk factors for overall survival. Perineural and venous-vascular invasion were detected as independent risk factors for disease-free survival. Lastly, anastomotic leak and venous-vascular invasion were detected as independent risk factors for local recurrence.
Keywords: Rectal cancer, rectal surgery, survival, local recurrence
Cite this article as: Tırnova İ, Işık Ö, Yılmazlar AT. Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. Turk J Surg 2023; 39 (3): 197-203.
This study was approved by Uludağ University Faculty of Medicine Clinical Research Ethics Committee (Decision no: 2016-15/18, Date: 09.08.2016).
Concept - ATY, İT; Design - ATY; Supervision - ÖI, ATY; Data Collection and/ or Processing - İT; Analysis and/or Interpretation - İT; Literature Search - İT, ÖI-; Writing Manuscript - All of auhtors; Critical Reviews - ÖI, ATY
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.