Anatomical prognostic factors after abdominal perineal resection

Journal Article · Wed Apr 01 04:00:00 EST 1981 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(81)90133-4· OSTI ID:6483122

Walz, B J; Green, M R; Lindstrom, E R; Butcher, Jr, H R

The natural history of 153 patients with rectosigmoid adenocarcinoma treated by abdominal perineal resection was retrospectively studied with emphasis on survival, clinical signs and symptoms of recurrence distantly and in the pelvis. We analyzed diagnostic factors that might predict tumor stage preoperatively and anatomical factors of the tumor itself that might predict behaviour of the lesion. Age, sex, tumor size, and distance from the anal verge were not useful in predicting stage. Constriction of the lesion tended to occur with high stage, but was not a reliable predictor. The grade or differentiation of the biopsy (when noted) did not correlate with either the grade of the resected specimen or the stage. The highest grade of the resected specimen was quite predictive of subsequent outcome. Seventy-three percent of the poorly differentiated tumors were Stage C or D, though a lower grade specimen did not rule out high stage. The Astler-Coller stage was reliable in predicting the likelihood of survival, pelvic recurrence, and distant metastases. In Stage C patients, the number of positive lymph node metastases strongly affected prognosis: if only one node was positive, survival was intermediate between Stages B and C; if more than seven nodes were positive, no patient survived. Of the evaluable cases, 48% survived clinically free of disease five or more years; 43% failed (died of the rectosigmoid tumor); 22% developed pelvic recurrence (6% pelvis only, 16% pelvis plus distant metastases). Fifty-two percent of the patients failing had tumor in the pelvis. Seven of the 56 failures (13%) occurred at or after five years; six of these seven failed locally, usually with metastases. Patients under age 40 or over age 80 and the same results as the group in general. Sixteen percent of the entire group had major complications, 52% minor. There were eight postoperative deaths (5%); 18 patients (12%) required reoperation.

• OSTI ID: 6483122
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 7:4; ISSN IOBPD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ABDOMEN
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BODY AREAS
CARCINOMAS
CARDIOVASCULAR DISEASES
DEATH
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM DISEASES
DISEASES
EMBOLI
EVALUATION
FISTULAE
GASTROINTESTINAL TRACT
GLANDS
HEMORRHAGE
INTESTINES
LARGE INTESTINE
MALE GENITALS
MEDICINE
METASTASES
MYOCARDIAL INFARCTION
NECROSIS
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PELVIS
PERITONITIS
PROSTATE
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RECTUM
SIDE EFFECTS
SURGERY
SURVIVAL CURVES
SYMPTOMS
THERAPY
URINARY TRACT