File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Outcomes of resection of stage IV rectal cancer with mesorectal excision

TitleOutcomes of resection of stage IV rectal cancer with mesorectal excision
Authors
KeywordsMesorectal resection
Stage IV rectal cancer
Issue Date2006
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/31873
Citation
Journal Of Surgical Oncology, 2006, v. 93 n. 7, p. 523-528 How to Cite?
AbstractBackground: There is no consensus as to the management of the primary rectal cancer in the presence of distant metastasis and data on the outcomes of radical resection in stage IV rectal cancer are limited. This study aims to evaluate the results of resection of rectal cancer in the patients with stage IV disease and to analyze the factors that might affect the survival of these patients. Methods: Of the 744 patients with radical resection of primary rectal and rectosigmoid cancer during the study period from August 1993 to July 2002, 70 had stage IV disease on the initial presentation. The demographics, the operative details, the tumor characteristics, the postoperative outcomes and survival of the patients were collected prospectively. Factors influencing the survival were analyzed with univariate and multivariate analysis. Results: Fifty-three men and 17 women with a median age of 66 years (range: 31-90 years) were included. The median level of the tumor from the anal verge was 10 cm (range 3-20 cm). The operations included abdominoperineal resection (n = 5), anterior resection (n = 53), and Hartmanns operation (n = 11). The operation mortality was 4.3%. The overall morbidity was 42.7% while the surgical morbidity and the reoperation rates were 15.7% and 5%, respectively. The local recurrence rate was 4.3% and the 2-year actuarial rate was 7.8%. All the patients who had local recurrences also had disseminated peritoneal metastasis. The median cancer-specific survival of the patients who survived the surgery was 15.2 months. Multivariate analysis showed that the presence of gross residual local disease, lymph node metastasis, liver involvement of over 50%, the absence of surgical management of liver metastasis and those without chemotherapy were independent factors associated with poor survival. Conclusions: Postoperative mortality and morbidity were acceptable in patients with stage IV rectal cancer. The local disease can be controlled effectively with radical resection. However, in patients with extensive liver involvement and advanced local disease, resection is not worthwhile because of the poor survival. Surgical management of the metastasis and the administration of chemotherapy are associated with better survival. However, the optional treatment regimes are yet to be defined. © 2006 Wiley-Liss, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/84124
ISSN
2015 Impact Factor: 3.151
2015 SCImago Journal Rankings: 1.349
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorChu, KWen_HK
dc.date.accessioned2010-09-06T08:49:13Z-
dc.date.available2010-09-06T08:49:13Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Surgical Oncology, 2006, v. 93 n. 7, p. 523-528en_HK
dc.identifier.issn0022-4790en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84124-
dc.description.abstractBackground: There is no consensus as to the management of the primary rectal cancer in the presence of distant metastasis and data on the outcomes of radical resection in stage IV rectal cancer are limited. This study aims to evaluate the results of resection of rectal cancer in the patients with stage IV disease and to analyze the factors that might affect the survival of these patients. Methods: Of the 744 patients with radical resection of primary rectal and rectosigmoid cancer during the study period from August 1993 to July 2002, 70 had stage IV disease on the initial presentation. The demographics, the operative details, the tumor characteristics, the postoperative outcomes and survival of the patients were collected prospectively. Factors influencing the survival were analyzed with univariate and multivariate analysis. Results: Fifty-three men and 17 women with a median age of 66 years (range: 31-90 years) were included. The median level of the tumor from the anal verge was 10 cm (range 3-20 cm). The operations included abdominoperineal resection (n = 5), anterior resection (n = 53), and Hartmanns operation (n = 11). The operation mortality was 4.3%. The overall morbidity was 42.7% while the surgical morbidity and the reoperation rates were 15.7% and 5%, respectively. The local recurrence rate was 4.3% and the 2-year actuarial rate was 7.8%. All the patients who had local recurrences also had disseminated peritoneal metastasis. The median cancer-specific survival of the patients who survived the surgery was 15.2 months. Multivariate analysis showed that the presence of gross residual local disease, lymph node metastasis, liver involvement of over 50%, the absence of surgical management of liver metastasis and those without chemotherapy were independent factors associated with poor survival. Conclusions: Postoperative mortality and morbidity were acceptable in patients with stage IV rectal cancer. The local disease can be controlled effectively with radical resection. However, in patients with extensive liver involvement and advanced local disease, resection is not worthwhile because of the poor survival. Surgical management of the metastasis and the administration of chemotherapy are associated with better survival. However, the optional treatment regimes are yet to be defined. © 2006 Wiley-Liss, Inc.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/31873en_HK
dc.relation.ispartofJournal of Surgical Oncologyen_HK
dc.rightsJournal of Surgical Oncology. Copyright © John Wiley & Sons, Inc.en_HK
dc.subjectMesorectal resectionen_HK
dc.subjectStage IV rectal canceren_HK
dc.titleOutcomes of resection of stage IV rectal cancer with mesorectal excisionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0022-4790&volume=93&issue=7&spage=523&epage=528&date=2006&atitle=Outcomes+of+resection+of+stage+IV+rectal+cancer+with+mesorectal+excisionen_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/jso.20506en_HK
dc.identifier.pmid16705728-
dc.identifier.scopuseid_2-s2.0-33744482015en_HK
dc.identifier.hkuros116710en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33744482015&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume93en_HK
dc.identifier.issue7en_HK
dc.identifier.spage523en_HK
dc.identifier.epage528en_HK
dc.identifier.isiWOS:000237894500004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridChu, KW=7402453653en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats