The impact of total mesorectal excision in middle and low rectal carcinomas

J BUON. 2010 Jan-Mar;15(1):56-60.

Abstract

Purpose: The incidence of locoregional recurrence in rectal cancer has declined since total mesorectal excision (TME) has been widely adopted. The purpose of this study was to investigate the long-term survival and the incidence of locoregional recurrences in patients with middle and low rectal carcinomas undergoing TME.

Methods: The medical records of 126 patients with middle and low rectal carcinomas treated from 1987-2007 were retrospectively reviewed. Of them 80 had undergone total mesorectal excision (TME-group) and 46 surgery with conventional methods (CON-group). Clinical variables were correlated to morbidity, hospital mortality, recurrence, sites of recurrence, and survival.

Results: The groups were comparable except for type of surgery and sites of recurrence. Five-year overall survival rate for TME group was 75% and for CON-group 47% (p=0.0346). Although the groups were not different for the total number of recurrences, the number of locoregional recurrences was significantly lower in TME group (p=0.004).

Conclusion: TME appears to improve long-term survival in patients with middle and low rectal carcinomas. The incidence of locoregional recurrence is also reduced by TME.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Carcinoma / mortality
  • Carcinoma / secondary
  • Carcinoma / surgery*
  • Chemotherapy, Adjuvant
  • Digestive System Surgical Procedures* / adverse effects
  • Digestive System Surgical Procedures* / mortality
  • Female
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Neoplasm Staging
  • Proctoscopy
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sigmoidoscopy
  • Time Factors
  • Treatment Outcome