25 YEARS OF EXPERIENCE WITH RADICAL SURGICAL TREATMENT OF CARCINOMA OF EXTRAPERITONEAL RECTUM

  • 1 January 1977
    • journal article
    • research article
    • Vol. 82  (4) , 460-465
Abstract
Between 1950 and 1975, 1100 patients with carcinoma of the rectum were seen. Of these, 519 had tumors below the peritoneal reflection. The resection rate in this latter group of patients was 94%. One hundred and thirty-three patients were treated by low anterior resection (LAR) and 316 by combined abdominoperineal resection (APR). Although the incidence of postoperative complications was high (LAR 41%, APR 53%), the operative mortality was low (LAR 2.2%, APR 2.9%). Recurrent tumor appeared more frequently in the pelvis (24%) than at distant sites (18%), was more common in more advanced disease and correlated with the incidence of the late death. The overall (actuarial) survival figures were 50% at 5 yr and 37% at 10 yr, with no significant difference between LAR and APR. For curative resections, the 5- and 10-yr survival figures were 59 and 44%, respectively. Clinical staging (Dukes) influenced survival greatly, at 5 yr (Dukes A 77%, B 65%, C 33%, D 3%) and 10 yr (Dukes A 55%, B 53%, C 20%, D 0%), The level of the lesion did not influence recurrence rate or survival.

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