Results after rectal cancer resection with in-continuity partial vaginectomy and total mesorectal excision Journal Article
| Authors: | Ruo, L.; Paty, P. B.; Minsky, B. D.; Wong, W. D.; Cohen, A. M.; Guillem, J. G. |
| Article Title: | Results after rectal cancer resection with in-continuity partial vaginectomy and total mesorectal excision |
| Abstract: | Background: Although sharp mesorectal excision reduces circumferential margin involvement and local recurrence, a concomitant partial vaginectomy may be required in women with locally advanced rectal cancer. Methods: Sixty-four patients requiring a partial vaginectomy during resection of primary rectal cancer were identified. Survival was determined by the Kaplan-Meier method, and distributions were compared by the log-rank test. Results: Locally advanced disease was reflected by presentation with malignant rectovaginal fistulae (n = 6) or cancers described as bulky or adherent/tethered to the rectovaginal septum (n = 32). Thirty-five patients received adjuvant radiation with or without chemotherapy. At a median follow-up of 22 months, 27 (42%) patients developed recurrent disease, with most of these occurring at distant sites. The 5-year overall survival was 46%, with a median survival of 44 months. The 2-year local recurrence-free survival was 84%. The crude local failure rate was 16% (10 of 64), and local recurrence was more common in patients with a positive as opposed to a negative microscopic margin (2 [50%] of 4 vs. 8 [13%] of 60, respectively). Positive nodal status had a significant effect on overall survival (P < .001). Conclusions: Partial vaginectomy is indicated for locally advanced rectal cancers involving the vagina. The results are most favorable in patients with negative surgical margins and node-negative disease. © 2003 The Society of Surgical Oncology, Inc. |
| Keywords: | survival; adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; cancer surgery; surgical technique; treatment failure; retrospective studies; major clinical study; cancer localization; cancer recurrence; fluorouracil; side effect; cancer radiotherapy; cancer staging; follow up; lymph node metastasis; cancer diagnosis; lymphatic metastasis; neoplasm recurrence, local; vagina; pathology; radiation injury; retrospective study; cancer invasion; statistical significance; tumor recurrence; neoplasm invasiveness; kaplan meier method; rectal neoplasms; rectum cancer; rectum tumor; drug induced disease; rectum surgery; rectal cancer; mesorectal excision; vaginectomy; humans; human; female; article; resection margins |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 10 |
| Issue: | 6 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2003-07-01 |
| Start Page: | 664 |
| End Page: | 668 |
| Language: | English |
| DOI: | 10.1245/aso.2003.04.026 |
| PUBMED: | 12839851 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 12 September 2014 -- Source: Scopus |
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