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Open Access 01-12-2022 | Rectal Cancer | Research

Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer

Authors: Haoyu Zhang, Ganbin Li, Ke Cao, Zhiwei Zhai, Guanghui Wei, Chunxiang Ye, Baocheng Zhao, Zhenjun Wang, Jiagang Han

Published in: BMC Surgery | Issue 1/2022

Abstract

Purpose

Extralevator (ELAPE) and abdominoperineal excision (APE) are two major surgical approaches for low rectal cancer patients. Although excellent short-term efficacy is achieved in patients undergoing ELAPE, the long-term benefits have not been established. In this study we evaluated the safety, pathological and survival outcomes in rectal cancer patients who underwent ELAPE and APE.

Methods

One hundred fourteen patients were enrolled, including 68 in the ELAPE group and 46 in the APE group at the Beijing Chaoyang Hospital, Capital Medical University from January 2011 to November 2020. The baseline characteristics, overall survival (OS), progression-free survival (PFS), and local recurrence-free survival (LRFS) were calculated and compared between the two groups.

Results

Demographics and tumor stage were comparable between the two groups. The 5-year PFS (67.2% versus 38.6%, log-rank P = 0.008) were significantly improved in the ELAPE group compared to the APE group, and the survival advantage was especially reflected in patients with pT3 tumors, positive lymph nodes or even those who have not received neoadjuvant chemoradiotherapy. Multivariate analysis showed that APE was an independent risk factor for OS (hazard ratio 3.000, 95% confidence interval 1.171 to 4.970, P = 0.004) and PFS (hazard ratio 2.730, 95% confidence interval 1.506 to 4.984, P = 0.001).

Conclusion

Compared with APE, ELAPE improved long-term outcomes for low rectal cancer patients, especially among patients with pT3 tumors, positive lymph nodes or those without neoadjuvant chemoradiotherapy.

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Title: Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer
Authors: Haoyu Zhang
Ganbin Li
Ke Cao
Zhiwei Zhai
Guanghui Wei
Chunxiang Ye
Baocheng Zhao
Zhenjun Wang
Jiagang Han
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Rectal Cancer
Rectal Cancer
Published in: BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-022-01692-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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