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Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis
Sphincter‐preserving procedures (SPPs) for surgical treatment of low‐lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881346/ https://www.ncbi.nlm.nih.gov/pubmed/29863157 http://dx.doi.org/10.1002/ags3.12032 |
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author | Okamura, Ryosuke Hida, Koya Yamaguchi, Tomohiro Akagi, Tomonori Konishi, Tsuyoshi Yamamoto, Michio Ota, Mitsuyoshi Matoba, Shuichiro Bando, Hiroyuki Goto, Saori Sakai, Yoshiharu Watanabe, Masahiko Watanabe, Kazuteru Otsuka, Koki Takemasa, Ichiro Tanaka, Keitaro Ikeda, Masataka Matsuda, Chu Fukuda, Meiki Hasegawa, Junichi Akamoto, Shintaro Shiozawa, Manabu Tsuruta, Atsushi Akiyoshi, Takashi Kato, Takeshi Tsukamoto, Shunsuke Ito, Masaaki Naito, Masaki Kanazawa, Akiyoshi Takahashi, Takao Ueki, Takashi Hayashi, Yuri Morita, Satoshi Yamaguchi, Takashi Nakanishi, Masayoshi Hasegawa, Hirotoshi Okamoto, Ken Teraishi, Fuminori Sumi, Yasuo Tashiro, Jo Yatsuoka, Toshimasa Nishimura, Yoji Okita, Kenji Kobatake, Takaya Horie, Hisanaga Miyakura, Yasuyuki Ro, Hisashi Nagakari, Kunihiko Hidaka, Eiji Umemoto, Takehiro Nishigori, Hideaki Murata, Kohei Wakayama, Fuminori Makizumi, Ryoji Fujii, Shoichi Sunami, Eiji Kobayashi, Hirotoshi Nakagawa, Ryosuke Enomoto, Toshiyuki Ohnuma, Shinobu Higashijima, Jun Ozawa, Heita Ashida, Keigo Fujita, Fumihiko Uehara, Keisuke Maruyama, Satoshi Ohyama, Masato Yamamoto, Seiichiro Hinoi, Takao Yoshimitsu, Masanori Okajima, Masazumi Tanimura, Shu Kawasaki, Masayasu Ide, Yoshihito Hazama, Shoichi Watanabe, Jun Inagaki, Daisuke Toyokawa, Akihiro |
author_facet | Okamura, Ryosuke Hida, Koya Yamaguchi, Tomohiro Akagi, Tomonori Konishi, Tsuyoshi Yamamoto, Michio Ota, Mitsuyoshi Matoba, Shuichiro Bando, Hiroyuki Goto, Saori Sakai, Yoshiharu Watanabe, Masahiko Watanabe, Kazuteru Otsuka, Koki Takemasa, Ichiro Tanaka, Keitaro Ikeda, Masataka Matsuda, Chu Fukuda, Meiki Hasegawa, Junichi Akamoto, Shintaro Shiozawa, Manabu Tsuruta, Atsushi Akiyoshi, Takashi Kato, Takeshi Tsukamoto, Shunsuke Ito, Masaaki Naito, Masaki Kanazawa, Akiyoshi Takahashi, Takao Ueki, Takashi Hayashi, Yuri Morita, Satoshi Yamaguchi, Takashi Nakanishi, Masayoshi Hasegawa, Hirotoshi Okamoto, Ken Teraishi, Fuminori Sumi, Yasuo Tashiro, Jo Yatsuoka, Toshimasa Nishimura, Yoji Okita, Kenji Kobatake, Takaya Horie, Hisanaga Miyakura, Yasuyuki Ro, Hisashi Nagakari, Kunihiko Hidaka, Eiji Umemoto, Takehiro Nishigori, Hideaki Murata, Kohei Wakayama, Fuminori Makizumi, Ryoji Fujii, Shoichi Sunami, Eiji Kobayashi, Hirotoshi Nakagawa, Ryosuke Enomoto, Toshiyuki Ohnuma, Shinobu Higashijima, Jun Ozawa, Heita Ashida, Keigo Fujita, Fumihiko Uehara, Keisuke Maruyama, Satoshi Ohyama, Masato Yamamoto, Seiichiro Hinoi, Takao Yoshimitsu, Masanori Okajima, Masazumi Tanimura, Shu Kawasaki, Masayasu Ide, Yoshihito Hazama, Shoichi Watanabe, Jun Inagaki, Daisuke Toyokawa, Akihiro |
author_sort | Okamura, Ryosuke |
collection | PubMed |
description | Sphincter‐preserving procedures (SPPs) for surgical treatment of low‐lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II‐III rectal cancer between 2010 and 2011. Patients with tumors 2‐5 cm from the anal verge and clinical stage T3‐4 were eligible. Primary outcome was 3‐year local recurrence rate, and confounding effects were minimized by propensity score matching. The study involved 794 patients (456 SPPs and 338 APR). Before matching, candidates for APR were more likely to have lower and advanced lesions, whereas SPPs were carried out more often following preoperative treatment, by laparoscopic approach, and at institutions with higher case volume. After matching, 398 patients (199 each for SPPs and APR) were included in the analysis sample. Postoperative morbidity was similar between the SPPs and APR groups (38% vs 39%; RR 0.98, 95% CI 0.77‐1.27). Margin involvement was present in eight patients in the SPPs group (one and seven at the distal and radial margins, respectively) and in 12 patients in the APR group. No difference in 3‐year local recurrence rate was noted between the two groups (11% vs 14%; HR 0.77, 95% CI 0.42‐1.41). In this observational study, comparability was ensured by adjusting for possible confounding factors. Our results suggest that SPPs and APR for locally advanced low rectal cancer have demonstrably equivalent oncological local control. |
format | Online Article Text |
id | pubmed-5881346 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-58813462018-06-01 Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis Okamura, Ryosuke Hida, Koya Yamaguchi, Tomohiro Akagi, Tomonori Konishi, Tsuyoshi Yamamoto, Michio Ota, Mitsuyoshi Matoba, Shuichiro Bando, Hiroyuki Goto, Saori Sakai, Yoshiharu Watanabe, Masahiko Watanabe, Kazuteru Otsuka, Koki Takemasa, Ichiro Tanaka, Keitaro Ikeda, Masataka Matsuda, Chu Fukuda, Meiki Hasegawa, Junichi Akamoto, Shintaro Shiozawa, Manabu Tsuruta, Atsushi Akiyoshi, Takashi Kato, Takeshi Tsukamoto, Shunsuke Ito, Masaaki Naito, Masaki Kanazawa, Akiyoshi Takahashi, Takao Ueki, Takashi Hayashi, Yuri Morita, Satoshi Yamaguchi, Takashi Nakanishi, Masayoshi Hasegawa, Hirotoshi Okamoto, Ken Teraishi, Fuminori Sumi, Yasuo Tashiro, Jo Yatsuoka, Toshimasa Nishimura, Yoji Okita, Kenji Kobatake, Takaya Horie, Hisanaga Miyakura, Yasuyuki Ro, Hisashi Nagakari, Kunihiko Hidaka, Eiji Umemoto, Takehiro Nishigori, Hideaki Murata, Kohei Wakayama, Fuminori Makizumi, Ryoji Fujii, Shoichi Sunami, Eiji Kobayashi, Hirotoshi Nakagawa, Ryosuke Enomoto, Toshiyuki Ohnuma, Shinobu Higashijima, Jun Ozawa, Heita Ashida, Keigo Fujita, Fumihiko Uehara, Keisuke Maruyama, Satoshi Ohyama, Masato Yamamoto, Seiichiro Hinoi, Takao Yoshimitsu, Masanori Okajima, Masazumi Tanimura, Shu Kawasaki, Masayasu Ide, Yoshihito Hazama, Shoichi Watanabe, Jun Inagaki, Daisuke Toyokawa, Akihiro Ann Gastroenterol Surg Original Articles Sphincter‐preserving procedures (SPPs) for surgical treatment of low‐lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II‐III rectal cancer between 2010 and 2011. Patients with tumors 2‐5 cm from the anal verge and clinical stage T3‐4 were eligible. Primary outcome was 3‐year local recurrence rate, and confounding effects were minimized by propensity score matching. The study involved 794 patients (456 SPPs and 338 APR). Before matching, candidates for APR were more likely to have lower and advanced lesions, whereas SPPs were carried out more often following preoperative treatment, by laparoscopic approach, and at institutions with higher case volume. After matching, 398 patients (199 each for SPPs and APR) were included in the analysis sample. Postoperative morbidity was similar between the SPPs and APR groups (38% vs 39%; RR 0.98, 95% CI 0.77‐1.27). Margin involvement was present in eight patients in the SPPs group (one and seven at the distal and radial margins, respectively) and in 12 patients in the APR group. No difference in 3‐year local recurrence rate was noted between the two groups (11% vs 14%; HR 0.77, 95% CI 0.42‐1.41). In this observational study, comparability was ensured by adjusting for possible confounding factors. Our results suggest that SPPs and APR for locally advanced low rectal cancer have demonstrably equivalent oncological local control. John Wiley and Sons Inc. 2017-08-14 /pmc/articles/PMC5881346/ /pubmed/29863157 http://dx.doi.org/10.1002/ags3.12032 Text en © 2017 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Okamura, Ryosuke Hida, Koya Yamaguchi, Tomohiro Akagi, Tomonori Konishi, Tsuyoshi Yamamoto, Michio Ota, Mitsuyoshi Matoba, Shuichiro Bando, Hiroyuki Goto, Saori Sakai, Yoshiharu Watanabe, Masahiko Watanabe, Kazuteru Otsuka, Koki Takemasa, Ichiro Tanaka, Keitaro Ikeda, Masataka Matsuda, Chu Fukuda, Meiki Hasegawa, Junichi Akamoto, Shintaro Shiozawa, Manabu Tsuruta, Atsushi Akiyoshi, Takashi Kato, Takeshi Tsukamoto, Shunsuke Ito, Masaaki Naito, Masaki Kanazawa, Akiyoshi Takahashi, Takao Ueki, Takashi Hayashi, Yuri Morita, Satoshi Yamaguchi, Takashi Nakanishi, Masayoshi Hasegawa, Hirotoshi Okamoto, Ken Teraishi, Fuminori Sumi, Yasuo Tashiro, Jo Yatsuoka, Toshimasa Nishimura, Yoji Okita, Kenji Kobatake, Takaya Horie, Hisanaga Miyakura, Yasuyuki Ro, Hisashi Nagakari, Kunihiko Hidaka, Eiji Umemoto, Takehiro Nishigori, Hideaki Murata, Kohei Wakayama, Fuminori Makizumi, Ryoji Fujii, Shoichi Sunami, Eiji Kobayashi, Hirotoshi Nakagawa, Ryosuke Enomoto, Toshiyuki Ohnuma, Shinobu Higashijima, Jun Ozawa, Heita Ashida, Keigo Fujita, Fumihiko Uehara, Keisuke Maruyama, Satoshi Ohyama, Masato Yamamoto, Seiichiro Hinoi, Takao Yoshimitsu, Masanori Okajima, Masazumi Tanimura, Shu Kawasaki, Masayasu Ide, Yoshihito Hazama, Shoichi Watanabe, Jun Inagaki, Daisuke Toyokawa, Akihiro Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis |
title | Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis |
title_full | Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis |
title_fullStr | Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis |
title_full_unstemmed | Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis |
title_short | Local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis |
title_sort | local control of sphincter‐preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: propensity score matched analysis |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5881346/ https://www.ncbi.nlm.nih.gov/pubmed/29863157 http://dx.doi.org/10.1002/ags3.12032 |
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