Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer

Tırnova, İsmail; Isik, Ozgen; Yılmazlar, Tuncay

doi:10.47717/turkjsurg.2023.5946

Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer

İsmail TIRNOVA, (Uludağ Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Kolorektal Cerrahi Anabilim Dalı, Bursa, Türkiye)

Özgen IŞIK, (Uludağ Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Kolorektal Cerrahi Anabilim Dalı, Bursa, Türkiye)

Ahmet Tuncay YILMAZLAR (Uludağ Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Kolorektal Cerrahi Anabilim Dalı, Bursa, Türkiye)

Turkish Journal of Surgery

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Yıl: 2023 Cilt: 39 Sayı: 3 Sayfa Aralığı: 197 - 203 Metin Dili: İngilizce DOI: 10.47717/turkjsurg.2023.5946 İndeks Tarihi: 02-11-2023

Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer

Öz:

Objective: In our study, it was aimed to evaluate the factors affecting oncological outcomes in resections for rectal cancer. Material and Methods: Between January 2010 and December 2014, patients with rectal tumors were analyzed retrospectively. Demographic and pathological data and oncological outcomes were analyzed as disease-free survival, overall survival, and local recurrence. Results: A total of 158 patients’ data were obtained. Median age was 60 (22-83). Fifty-three patients were older than 65 years of age (138). Ninety-five (60%) patients were males, and 63 (40%) were females. Eighty patients (50.4%) had middle rectal, and 78 (49.6) patients had lower rectal cancer. There was no effect of tumor localization on oncological outcomes. Univariate analyses revealed the effects of age (p= 0.003), operation type (p< 0.001), nodal status (p< 0.001), malignant lymph node ratio (p< 0.001), stage of the disease (p< 0.001), distal resection margin (p= 0.047), perineural invasion (p< 0.001), lymphatic invasion (p< 0.001), venous-vascular invasion (p= 0.025), local recurrence (p< 0.001) and distant metastasis (p< 0.001) on overall survival rates. Univariate analyses revealed the effects of nodal status (p= 0.007), malignant lymph node ratio (p= 0.005), stage of the disease (p= 0.008), perineural invasion (p= 0.004) and venous-vascular invasion (p< 0.001) on disease-free survival rates. Univariate analyses revealed the effects of anastomotic leak (p= 0.015) and venous-vascular invasion (p= 0.001) on local recurrence rates. Conclusion: Older age, advanced nodal status, and distant metastasis were detected as independent risk factors for overall survival. Perineural and venous-vascular invasion were detected as independent risk factors for disease-free survival. Lastly, anastomotic leak and venous-vascular invasion were detected as independent risk factors for local recurrence.

Anahtar Kelime: Rectal cancer rectal surgery survival local recurrence

Orta ve distal yerleşimli rektum kanserinin cerrahi rezeksiyonlarında onkolojik sonuçlara etkili faktörler

Öz:

Giriş ve Amaç: Çalışmamızda rektum kanseri rezeksiyonlarında onkolojik sonuçları etkileyen faktörleri değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2010 ile Aralık 2014 tarihleri arasında rektum tümörü olan ve ameliyat edilen hastalar retrospektif olarak incelendi. Demografik ve patolojik verilerin yanında onkolojik sonuçlar, hastalıksız sağkalım, genel sağkalım ve lokal nüks olarak incelendi. Bulgular: Toplam 158 hasta çalışmaya dahil edildi. Ortanca yaş 60 (22-83) idi. Elli üç hasta 65 yaşından büyüktü (138). Hastaların 95’i (%60) erkek, 63’ü (%40) kadın idi. Seksen (%50,4) hastada orta, 78 (49,6) hastada alt rektum kanseri vardı. Tümör lokalizasyonunun onkolojik sonuçlar üzerinde etkisi yoktu. Tek değişkenli analizlerde sağkalıma etkili faktörler yaş (p= 0,003), operasyon tipi (p< 0,001), nodal durum (p< 0,001), malign lenf nodu oranı (p< 0,001), hastalığın evresi (p< 0,001), distal rezeksiyon sınırı (p= 0,047), perinöral invazyon (p< 0,001), lenfatik invazyon (p< 0,001), venöz-vasküler invazyon (p= 0,025), lokal nüks (p< 0,001) ve uzak metastaz (p< 0,001) olması saptandı. Tek değişkenli analizlerde hastalıksız sağkalım için etkili faktörler; ileri nodal durum (p= 0,007), malign lenf nodu oranı (p= 0,005), hastalığın evresi (p= 0,008), perinöral invazyon (p= 0,004) ve venöz-vasküler invazyon (p< 0,001) olması saptandı. Tek değişkenli analizlerde lokal nükse etkili faktörler olarak anastomoz kaçağı- nın olması (p= 0,015) ve venöz-vasküler invazyonun (p= 0,001) olması saptandı. Sonuç: İleri yaş, ileri nodal durum ve uzak metastaz gelişmesi genel sağkalım için bağımsız risk faktörleri olarak saptandı. Perinöral ve venöz- vasküler invazyon hastalıksız sağkalım için bağımsız risk faktörleri olarak tespit edildi. Son olarak anastomoz kaçağı gelişmesi ve venöz-vasküler invazyon olması lokal nüks için bağımsız risk faktörleri olarak tespit edildi.

Anahtar Kelime: Rektum kanseri rektum cerrahisi sağkalım lokal nüks

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Tırnova İ, Isik O, Yılmazlar T (2023). Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. , 197 - 203. 10.47717/turkjsurg.2023.5946
Chicago	Tırnova İsmail,Isik Ozgen,Yılmazlar Tuncay Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. (2023): 197 - 203. 10.47717/turkjsurg.2023.5946
MLA	Tırnova İsmail,Isik Ozgen,Yılmazlar Tuncay Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. , 2023, ss.197 - 203. 10.47717/turkjsurg.2023.5946
AMA	Tırnova İ,Isik O,Yılmazlar T Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. . 2023; 197 - 203. 10.47717/turkjsurg.2023.5946
Vancouver	Tırnova İ,Isik O,Yılmazlar T Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. . 2023; 197 - 203. 10.47717/turkjsurg.2023.5946
IEEE	Tırnova İ,Isik O,Yılmazlar T "Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer." , ss.197 - 203, 2023. 10.47717/turkjsurg.2023.5946
ISNAD	Tırnova, İsmail vd. "Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer". (2023), 197-203. https://doi.org/10.47717/turkjsurg.2023.5946

APA	Tırnova İ, Isik O, Yılmazlar T (2023). Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. Turkish Journal of Surgery, 39(3), 197 - 203. 10.47717/turkjsurg.2023.5946
Chicago	Tırnova İsmail,Isik Ozgen,Yılmazlar Tuncay Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. Turkish Journal of Surgery 39, no.3 (2023): 197 - 203. 10.47717/turkjsurg.2023.5946
MLA	Tırnova İsmail,Isik Ozgen,Yılmazlar Tuncay Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. Turkish Journal of Surgery, vol.39, no.3, 2023, ss.197 - 203. 10.47717/turkjsurg.2023.5946
AMA	Tırnova İ,Isik O,Yılmazlar T Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. Turkish Journal of Surgery. 2023; 39(3): 197 - 203. 10.47717/turkjsurg.2023.5946
Vancouver	Tırnova İ,Isik O,Yılmazlar T Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer. Turkish Journal of Surgery. 2023; 39(3): 197 - 203. 10.47717/turkjsurg.2023.5946
IEEE	Tırnova İ,Isik O,Yılmazlar T "Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer." Turkish Journal of Surgery, 39, ss.197 - 203, 2023. 10.47717/turkjsurg.2023.5946
ISNAD	Tırnova, İsmail vd. "Risk factors affecting oncological outcomes of surgical resections for middle and lower rectal cancer". Turkish Journal of Surgery 39/3 (2023), 197-203. https://doi.org/10.47717/turkjsurg.2023.5946