LOGO
pl en

The effectiveness of multimodality management of the rectal cancer in females

Bartłomiej Szynglarewicz1, Rafał Matkowski1,2, Urszula Ochenduszkiewicz1,2, Daniel Sydor3, Józef Forgacz1, Marek Pudełko1, Jan Kornafel2

Affiliacja i adres do korespondencji
GIN ONKOL 2006, 4 (2), p. 108-114
Streszczenie

Rectal cancer incidence among females in Poland increases. Surgery remains the mainstay of treatment. Anterior resection with total mesorectal excision (TME) is the preferred option in the most cases. Some patients have locally advanced tumours or synchronous gynaecologic abnormalities and need extended resections. Objective: Aim of the study was the evaluation of incidence and pattern of concomitant gynaecologic lesions and analysis of impact of multimodality co-operation between surgeon and gynaecologist on functional and oncological outcomes. Material and methods: Consecutive 34 women (age 35-81, mean 59.6) underwent R0 resection with sphincter-preserving TME from 01.1998 to 12.1999 and were studied prospectively. Follow-up period was five years. Results: 9% females underwent hysterectomy or adnexectomy previously. At the time of surgery 36% had abnormal internal genitalia: 15% at the uterus, 6% at ovaries, 6% at uterus and ovaries, in 9% adherence to the rectum was found. In 3% malignant infiltration was microscopically confirmed. No postoperative mortality was noticed. Anastomotic leakage developed in 9%, postoperative bleeding in 3%, delayed wound healing in 12%, prolonged bowel paralysis in 3%, anterior resection syndrome in 6%, urological disturbances in 9%. Isolated local recurrences were found in 6%. 64% five-year overall survival was achieved. Survival rate was 91.7% in Dukes A, 63.6% in B and 36.4% in C (p<0.05). Conclusions: Numerous females with rectal cancer have gynaecologic abnormalities and need extended resections. Due to adequate co-operation of surgeon and gynaecologist and optimal multimodality management, acceptable postoperative morbidity and optimising oncological outcomes can be achieved.

Słowa kluczowe
rectal cancer, anterior resection, total mesorectal excision (TME), hysterectomy, adnexectomy