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World J Gastroenterol. Jul 21, 2014; 20(27): 9138-9145
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9138
Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9138
Abdominoperineal excision following preoperative radiotherapy for rectal cancer: Unfavorable prognosis even with negative circumferential resection margin
Lin Wang, Yi-Fan Peng, Jin Gu, Department of Colorectal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
Zhong-Wu Li, Department of Pathology, Department of Gastroenterology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
Guo-Li Gu, Department of General Surgery, Air Force General Hospital, Beijing 100142, China
Author contributions: Wang L, Gu GL, Li ZW and Peng YF contributed equally to this study; Wang L contributed to collecting data, designing research and writing article; Gu GL contributed to drafting and revising the article; Li ZW contributed to pathological quality control and assessment; Peng YF contributed to references management; Gu J contributed to the final approval of this article.
Supported by Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (code ZY201410)
Correspondence to: Jin Gu, MD, FACS, Department of Colorectal Surgery, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fuchenglu Road, Beijing 100142, China. zlgujin@126.com
Telephone: +86-10-88196085 Fax: +86-10-88196085
Received: January 26, 2014
Revised: March 10, 2014
Accepted: April 15, 2014
Published online: July 21, 2014
Revised: March 10, 2014
Accepted: April 15, 2014
Published online: July 21, 2014
Core Tip
Core tip: The present study focused on survival differences between rectal cancer treated with abdominoperineal excision or non-abdominoperineal excision (APE) following preoperative radiotherapy, with the adjustments of the circumferential resection margin (CRM) to preclude the influence of surgical radicality. The results revealed the more aggressive oncological behavior of low-lying or fixed tumors, which were unavailable for the sphincter preservation procedure even with negative CRM. We also emphasized the importance of preoperative staging and decision-making before APE procedure, and reviewed the related hypotheses for the unfavorable local control of APE in the discussion.