Influence of the level of sacrectomy on survival in patients with locally advanced and recurrent rectal cancer. BJS 2019; 106: 484-490.
Published: 16th January 2019
Authors: Y. C. Lau, K. Jongerius, C. Wakeman, A. G. Heriot, M. J. Solomon, P. M. Sagar et al.
Exenterative surgery for locally advanced rectal cancer may involve partial sacrectomy to achieve complete resection. High sacrectomy is technically challenging, and can be associated with high morbidity and mortality rates. The aim of this study was to determine the influence of the level of sacrectomy on the survival of patients with locally advanced rectal cancer.
This was an international multicentre retrospective analysis of patients undergoing exenterative abdominosacrectomy between July 2006 and June 2016. High sacrectomy was defined as resection at or above the junction of S2–S3; low sacrectomy was below the S2–S3 junction. Kaplan–Meier survival analysis was used to assess overall survival and cancer‐specific survival. Predictive factors were determined using Cox regression analysis.
A total of 345 patients were identified, of whom 91 underwent high sacrectomy and 254 low sacrectomy. There was no difference in 5‐year overall survival (53 versus 44·1 per cent; P = 0·216) or cancer‐specific survival (60 versus 56·1 per cent; P = 0·526) between high and low sacrectomy. Negative margin rates were similar for primary and recurrent disease: 65 of 90 (72 per cent) versus 97 of 153 (63·4 per cent) (P = 0·143). Level of sacrectomy was not a significant predictor of mortality (P = 0·053). Positive resection margin and advancing age were the only significant predictors for death, with hazard ratios of 2·78 (P < 0·001) and 1·02 (P = 0·020) respectively.
There was no survival difference between patients who underwent high or low sacrectomy. In appropriately selected patients, high sacrectomy is feasible and safe.Full text
You may also be interested in
Bowel dysfunction after sigmoid resection for cancer and its impact on quality of life. BJS 2019; 106: 805-805.
Authors: H. Elfeki, H. M. Larsen, K. J. Emmertsen, P. Christensen, M. Youssef, W. Khafagy et al.
Serum carcinoembryonic antigen trends for diagnosing colorectal cancer recurrence in the FACS randomized clinical trial. BJS 2019; 106: 728-728.
Authors: B. Shinkins, J. N. Primrose, S. A. Pugh, B. D. Nicholson, R. Perera, T. James et al.
Authors: I. S. Reynolds, S. J. Furney, E. W. Kay, D. A. McNamara, J. H. M. Prehn, J. P. Burke et al.
Randomized clinical trial
Randomized clinical trial of liposomal bupivacaine transverse abdominis plane block versus intrathecal analgesia in colorectal surgery. BJS 2019; 106: 692-699.
Authors: D. T. Colibaseanu, O. Osagiede, A. Merchea, C. T. Ball, E. Bojaxhi, J. K. Panchamia et al.
Impact of enhanced recovery on oncological outcomes following minimally invasive surgery for rectal cancer.
Authors: B. J. Quiram, J. Crippa, F. Grass, J. K. Lovely, K. T. Behm, D. T. Colibaseanu et al.
Multicentre study of non‐surgical management of diverticulitis with abscess formation. BJS 2019; 106: 458-466.
Authors: D. P. V. Lambrichts, H. E. Bolkenstein, D. C. H. E. van der Does, D. Dieleman, R. M. P. H. Crolla, J. W. T. Dekker et al.
Randomized clinical trial
Randomized clinical trial of selective decontamination of the digestive tract in elective colorectal cancer surgery (SELECT trial). BJS 2019; 106: 355-363.
Authors: G. S. A. Abis, H. B. A. C. Stockmann, H. J. Bonjer, N. van Veenendaal, M. L. M. van Doorn‐Schepens, A. E. Budding et al.
Population‐based study of surgical treatment with and without tumour resection in patients with locally recurrent rectal cancer. BJS 2019; 106: 790-798.
Authors: K. Westberg, G. Palmer, F. Hjern, T. Holm, A. Martling
Patient‐reported functional and quality‐of‐life outcomes after transanal total mesorectal excision. BJS 2019; 106: 364-366.
Authors: D. S. Keller, C. Reali, A. Spinelli, M. Penna, F. Di Candido, C. Cunningham et al.
Effect of care continuity on mortality of patients readmitted after colorectal surgery. BJS 2019; 106: 636-644.
Authors: C. F. Justiniano, Z. Xu, A. Z. Becerra, C. T. Aquina, C. I. Boodry, L. K. Temple et al.
Functional outcomes from a randomized trial of early closure of temporary ileostomy after rectal excision for cancer. BJS 2019; 106: 645-652.
Authors: C. Keane, J. Park, S. Öberg, A. Wedin, D. Bock, G. O'Grady et al.
Long‐term functional outcomes and quality of life in patients with Hirschsprung’s disease. BJS 2019; 106: 499-507.
Authors: R. J. Meinds, A. F. W. van der Steeg, C. E. J. Sloots, M. J. Witvliet, I. de Blaauw, W. G. van Gemert et al.