Comparative analysis of organ preservation attempt and radical surgery in clinical T2N0 mid to low rectal cancer.

Autor: Park HM; Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Republic of Korea., Lee J; Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Republic of Korea., Lee SY; Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Republic of Korea., Kim CH; Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Republic of Korea., Kim HR; Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Republic of Korea. drkhr@chonnam.ac.kr.
Jazyk: angličtina
Zdroj: International journal of colorectal disease [Int J Colorectal Dis] 2024 Aug 20; Vol. 39 (1), pp. 136. Date of Electronic Publication: 2024 Aug 20.
DOI: 10.1007/s00384-024-04708-6
Abstrakt: Purpose: Debate persists regarding the feasibility of adopting an organ-preserving strategy as the treatment modality for clinical T2N0 rectal cancer. This study aimed to compare the outcomes of attempting organ-preserving strategies versus radical surgery in patients with clinical T2N0 mid to low rectal cancer.
Methods: Patients diagnosed with clinical T2N0 rectal cancer, with lesions located within 8 cm from the anal verge as determined by pre-treatment magnetic resonance imaging between January 2010 and December 2020 were included.
Results: Of 119 patients, 91 and 28 were categorized into the organ-preserving attempt group and the radical surgery group, respectively. The median follow-up duration was 48.8 months (range, 0-134 months). The organ-preserving attempt group exhibited a reduced incidence of stoma formation (44.0% vs. 75.0%; p = 0.004) and a lower occurrence of grade 3 or higher surgical complications (5.8% vs. 21.4%; p = 0.025). Univariate analyses revealed no significant association between treatment strategy and 3-year local recurrence-free survival (organ-preserving attempt 87.9% vs. radical surgery 96.2%; p = 0.129), or 3-year disease-free survival (79.6% vs. 84.9%; p = 0.429). Multivariate analysis did not identify any independent prognostic factors associated with oncologic outcomes.
Conclusion: Compared with radical surgery, attempted organ preservation resulted in lower incidences of stoma formation and severe surgical complications, whereas oncological outcomes were comparable. Attempting organ preservation may be a safe alternative to radical surgery for clinical T2N0 mid to low rectal cancer.
(© 2024. The Author(s).)
Databáze: MEDLINE
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