Sphincter-saving resection, or not, for cancer of the midrectum

Am J Surg. 1997 Jul;174(1):11-5. doi: 10.1016/S0002-9610(97)00023-8.


Background: The purpose of this study was to compare the time to pelvic recurrence and survival after sphincter-saving resection (SSR) or abdominoperineal resection (APR).

Methods: Out of the 119 patients with a cancer of the midrectum, 43 had undergone a SSR and 76 an APR for cure. To eliminate bias of a nonrandomized retrospective comparison, an adjustment for baseline prognostic covariates was used.

Results: Pelvic recurrence rates and survival distribution according to the type of resection did not differ significantly, with P values of 0.31 and 0.95, respectively, by the log-rank test. The Cox regression model incorporated nine binary covariates and the treatment group. Given these nine covariates, treatment did not influence either pelvic recurrence (adjusted P value = 0.62, relative risk = 0.78) or overall survival (adjusted P value = 0.89, relative risk = 1.05).

Conclusion: These results suggest that, in patients with cancer of the midrectum treated by SSR or APR, recurrence and survival rates are similar.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Methods
  • Middle Aged
  • Pelvic Neoplasms / pathology
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Survival Rate