Multicenter study of outcome in relation to the type of resection in rectal cancer

Hector Ortiz; Arne Wibe; Miguel Angel Ciga; Esther Kreisler; Eduardo Garcia-Granero; Jose Vicente Roig; Sebastiano Biondo; Juan Lujan; Doménico Fraccalvieri; Pedro Armendáriz; Mario De Miguel; Alejandro Espí; Antonio Codina; María D. Ruiz; Eloy Espin; Rosana Palasí; Alberto Parajo; Ignasi Camps; Marta Piñol; Enrique Pellicer; Vicent Viciano; Evelio Alonso; Miguel Pera; Teresa García; Enrique Casal; Jacinto Garcia; Marcos Rodríguez; Ángel Reina; José Errasti; José A. Múgica; José Gomez; Ricardo Rada; Mónica Orelogio; Natalia Uribe; Juan De Dios Franco; Antonio Arroyo; José Enrique Sierra; Pilar Hernandez; Jesús Paredes; Gabriel Martínez; Mauricio Garcia; Guillermo Carreño; Jesús Cifuentes; José Monzón; Olga Maseda; Daniel Huerga; Calin Pavel; Fernando Gris; Inmaculada Segura; Pablo Palma; José Gregorio Díaz; José Luis Jiménez; Francisco Pérez; Vicente Portugal; Juan C. Bernal; Félix Lluis; Luis Capitán; Nieves Cáceres; Javier Martínez; Alfredo Estévez; María Victoria Maestre; José Manuel Díaz; Mónica Reig; Antonio Amaya; José Antonio Carmona; Francisco J. Jiménez; Dídac Ribéi Serrat; Isabel Prieto; Damian Garcia; Tomas González De Francisco; Amor Turienzo; Manuel Martinez; Sergio Del Valle; Pedro Parra; Francisco Romero; Alessandro Garcea; Xavier Rodamilans O De La; Alberto Pérez; Guillermo Ais; Luis Ortiz De Zarate; Jesús Sánchez; Rafael Estevan; Albert Sueiras; Alberto Lamiquiz; Andoni Larzabal; Javier Die; Amparo Solana; Francisco Javier Blanco; Ana Ma Lage; José L. Domínguez; Paula Dujovne; Natividad Palencia; Rafael García; Raul Adell; Roberto Martínez; Ana Ma Huidobro; Carlos Pastor; Jesús Garijo; Ángel Carrillo; Ma Del Coral De La Vega; Manuel López

doi:10.1097/DCR.0000000000000026

Multicenter study of outcome in relation to the type of resection in rectal cancer

Hector Ortiz, Arne Wibe, Miguel Angel Ciga, Esther Kreisler, Eduardo Garcia-Granero, Jose Vicente Roig, Sebastiano Biondo^*, Juan Lujan, Doménico Fraccalvieri, Pedro Armendáriz, Mario De Miguel, Alejandro Espí, Antonio Codina, María D. Ruiz, Eloy Espin, Rosana Palasí, Alberto Parajo, Ignasi Camps, Marta Piñol, Enrique PellicerVicent Viciano, Evelio Alonso, Miguel Pera, Teresa García, Enrique Casal, Jacinto Garcia, Marcos Rodríguez, Ángel Reina, José Errasti, José A. Múgica, José Gomez, Ricardo Rada, Mónica Orelogio, Natalia Uribe, Juan De Dios Franco, Antonio Arroyo, José Enrique Sierra, Pilar Hernandez, Jesús Paredes, Gabriel Martínez, Mauricio Garcia, Guillermo Carreño, Jesús Cifuentes, José Monzón, Olga Maseda, Daniel Huerga, Calin Pavel, Fernando Gris, Inmaculada Segura, Pablo Palma, José Gregorio Díaz, José Luis Jiménez, Francisco Pérez, Vicente Portugal, Juan C. Bernal, Félix Lluis, Luis Capitán, Nieves Cáceres, Javier Martínez, Alfredo Estévez, María Victoria Maestre, José Manuel Díaz, Mónica Reig, Antonio Amaya, José Antonio Carmona, Francisco J. Jiménez, Dídac Ribéi Serrat, Isabel Prieto, Damian Garcia, Tomas González De Francisco, Amor Turienzo, Manuel Martinez, Sergio Del Valle, Pedro Parra, Francisco Romero, Alessandro Garcea, Xavier Rodamilans O De La, Alberto Pérez, Guillermo Ais, Luis Ortiz De Zarate, Jesús Sánchez, Rafael Estevan, Albert Sueiras, Alberto Lamiquiz, Andoni Larzabal, Javier Die, Amparo Solana, Francisco Javier Blanco, Ana Ma Lage, José L. Domínguez, Paula Dujovne, Natividad Palencia, Rafael García, Raul Adell, Roberto Martínez, Ana Ma Huidobro, Carlos Pastor, Jesús Garijo, Ángel Carrillo, Ma Del Coral De La Vega, Manuel López

^*Autor corresponent d’aquest treball

Departament de Cirurgia

Producció científica: Contribució a revista › Article › Recerca › Avaluat per experts

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BACKGROUND: A surgical teaching and auditing program has been implemented to improve the results of treatment for patients with rectal cancer. OBJECTIVE: The aim of this study was to assess the treatment and outcome in patients resected for rectal cancer, focusing on differences relating to the type of resection. DESIGN: This was an observational study. SETTINGS: The study took place throughout the network of hospitals that compose the National Health Service in Spain. PATIENTS: This study included a consecutive cohort of 3355 patients from the Spanish Rectal Cancer Project. The data of patients who were operated on electively, with curative intent, by anterior resection (n = 2333 [69.5%]), abdominoperineal excision (n = 774 [23.1%]), and Hartmann procedure (n = 248 [7.4%]) between March 2006 and May 2010 were analyzed. MAIN OUTCOME MEASURES: Clinical, pathologic, and outcome results were analyzed in relation to the type of surgery performed. RESULTS: After a median follow-up time of 37 months (interquartile range, 30-48 months), bowel perforations were found to be more common in the Hartmann procedure (12.6%) and abdominoperineal groups (10.1%) than in the anterior resection group (2.3%; p < 0.001). Involvement of the circumferential resection margin was also more common in the Hartmann (16.6%) and abdominoperineal groups (14.3%) than in the anterior resection group (6.6%; p < 0.001). Multivariate analysis showed a negative influence on local recurrence, metastasis, survival for advanced stage, intraoperative perforation, invaded circumferential margin, and Hartmann procedure. However, abdominoperineal excision did not significantly influence local recurrence (HR, 0.945; 95% CI, 0.571- 1.563; p = 0.825). LIMITATIONS: The main weakness of this study was the voluntary nature of registration in the Spanish Rectal Cancer Project. CONCLUSIONS: Although bowel perforation and involvement of the circumferential resection margin were more common after abdominoperineal excision than after anterior resection, this study did not identify abdominoperineal excision as a determinant of local recurrence in the context of 3 years of median follow-up.

Idioma original	Anglès
Pàgines (de-a)	811-822
Nombre de pàgines	12
Revista	Diseases of the Colon and Rectum
Volum	57
Número	7
DOIs	https://doi.org/10.1097/DCR.0000000000000026
Estat de la publicació	Publicada - 2014

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10.1097/DCR.0000000000000026

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Ortiz, H., Wibe, A., Ciga, M. A., Kreisler, E., Garcia-Granero, E., Roig, J. V., Biondo, S., Lujan, J., Fraccalvieri, D., Armendáriz, P., De Miguel, M., Espí, A., Codina, A., Ruiz, M. D., Espin, E., Palasí, R., Parajo, A., Camps, I., Piñol, M., ... López, M. (2014). Multicenter study of outcome in relation to the type of resection in rectal cancer. Diseases of the Colon and Rectum, 57(7), 811-822. https://doi.org/10.1097/DCR.0000000000000026

@article{b96e325e4b21495b950986880e366ea0,

title = "Multicenter study of outcome in relation to the type of resection in rectal cancer",

abstract = "BACKGROUND: A surgical teaching and auditing program has been implemented to improve the results of treatment for patients with rectal cancer. OBJECTIVE: The aim of this study was to assess the treatment and outcome in patients resected for rectal cancer, focusing on differences relating to the type of resection. DESIGN: This was an observational study. SETTINGS: The study took place throughout the network of hospitals that compose the National Health Service in Spain. PATIENTS: This study included a consecutive cohort of 3355 patients from the Spanish Rectal Cancer Project. The data of patients who were operated on electively, with curative intent, by anterior resection (n = 2333 [69.5%]), abdominoperineal excision (n = 774 [23.1%]), and Hartmann procedure (n = 248 [7.4%]) between March 2006 and May 2010 were analyzed. MAIN OUTCOME MEASURES: Clinical, pathologic, and outcome results were analyzed in relation to the type of surgery performed. RESULTS: After a median follow-up time of 37 months (interquartile range, 30-48 months), bowel perforations were found to be more common in the Hartmann procedure (12.6%) and abdominoperineal groups (10.1%) than in the anterior resection group (2.3%; p < 0.001). Involvement of the circumferential resection margin was also more common in the Hartmann (16.6%) and abdominoperineal groups (14.3%) than in the anterior resection group (6.6%; p < 0.001). Multivariate analysis showed a negative influence on local recurrence, metastasis, survival for advanced stage, intraoperative perforation, invaded circumferential margin, and Hartmann procedure. However, abdominoperineal excision did not significantly influence local recurrence (HR, 0.945; 95% CI, 0.571- 1.563; p = 0.825). LIMITATIONS: The main weakness of this study was the voluntary nature of registration in the Spanish Rectal Cancer Project. CONCLUSIONS: Although bowel perforation and involvement of the circumferential resection margin were more common after abdominoperineal excision than after anterior resection, this study did not identify abdominoperineal excision as a determinant of local recurrence in the context of 3 years of median follow-up.",

keywords = "Abdominoperineal resection, Local recurrence, Metastases, Overall survival, Rectal cancer",

author = "Hector Ortiz and Arne Wibe and Ciga, {Miguel Angel} and Esther Kreisler and Eduardo Garcia-Granero and Roig, {Jose Vicente} and Sebastiano Biondo and Juan Lujan and Dom{\'e}nico Fraccalvieri and Pedro Armend{\'a}riz and {De Miguel}, Mario and Alejandro Esp{\'i} and Antonio Codina and Ruiz, {Mar{\'i}a D.} and Eloy Espin and Rosana Palas{\'i} and Alberto Parajo and Ignasi Camps and Marta Pi{\~n}ol and Enrique Pellicer and Vicent Viciano and Evelio Alonso and Miguel Pera and Teresa Garc{\'i}a and Enrique Casal and Jacinto Garcia and Marcos Rodr{\'i}guez and {\'A}ngel Reina and Jos{\'e} Errasti and M{\'u}gica, {Jos{\'e} A.} and Jos{\'e} Gomez and Ricardo Rada and M{\'o}nica Orelogio and Natalia Uribe and {De Dios Franco}, Juan and Antonio Arroyo and Sierra, {Jos{\'e} Enrique} and Pilar Hernandez and Jes{\'u}s Paredes and Gabriel Mart{\'i}nez and Mauricio Garcia and Guillermo Carre{\~n}o and Jes{\'u}s Cifuentes and Jos{\'e} Monz{\'o}n and Olga Maseda and Daniel Huerga and Calin Pavel and Fernando Gris and Inmaculada Segura and Pablo Palma and D{\'i}az, {Jos{\'e} Gregorio} and Jim{\'e}nez, {Jos{\'e} Luis} and Francisco P{\'e}rez and Vicente Portugal and Bernal, {Juan C.} and F{\'e}lix Lluis and Luis Capit{\'a}n and Nieves C{\'a}ceres and Javier Mart{\'i}nez and Alfredo Est{\'e}vez and Maestre, {Mar{\'i}a Victoria} and D{\'i}az, {Jos{\'e} Manuel} and M{\'o}nica Reig and Antonio Amaya and Carmona, {Jos{\'e} Antonio} and Jim{\'e}nez, {Francisco J.} and Serrat, {D{\'i}dac Rib{\'e}i} and Isabel Prieto and Damian Garcia and {De Francisco}, {Tomas Gonz{\'a}lez} and Amor Turienzo and Manuel Martinez and {Del Valle}, Sergio and Pedro Parra and Francisco Romero and Alessandro Garcea and {O De La}, {Xavier Rodamilans} and Alberto P{\'e}rez and Guillermo Ais and {De Zarate}, {Luis Ortiz} and Jes{\'u}s S{\'a}nchez and Rafael Estevan and Albert Sueiras and Alberto Lamiquiz and Andoni Larzabal and Javier Die and Amparo Solana and Blanco, {Francisco Javier} and {Ma Lage}, Ana and Dom{\'i}nguez, {Jos{\'e} L.} and Paula Dujovne and Natividad Palencia and Rafael Garc{\'i}a and Raul Adell and Roberto Mart{\'i}nez and {Ma Huidobro}, Ana and Carlos Pastor and Jes{\'u}s Garijo and {\'A}ngel Carrillo and {De La Vega}, {Ma Del Coral} and Manuel L{\'o}pez",

note = "Publisher Copyright: {\textcopyright} The ASCRS 2014.",

year = "2014",

doi = "10.1097/DCR.0000000000000026",

language = "English",

volume = "57",

pages = "811--822",

journal = "Diseases of the Colon and Rectum",

issn = "0012-3706",

publisher = "Lippincott Williams and Wilkins",

number = "7",

}

Ortiz, H, Wibe, A, Ciga, MA, Kreisler, E, Garcia-Granero, E, Roig, JV, Biondo, S, Lujan, J, Fraccalvieri, D, Armendáriz, P, De Miguel, M, Espí, A, Codina, A, Ruiz, MD, Espin, E, Palasí, R, Parajo, A, Camps, I, Piñol, M, Pellicer, E, Viciano, V, Alonso, E, Pera, M, García, T, Casal, E, Garcia, J, Rodríguez, M, Reina, Á, Errasti, J, Múgica, JA, Gomez, J, Rada, R, Orelogio, M, Uribe, N, De Dios Franco, J, Arroyo, A, Sierra, JE, Hernandez, P, Paredes, J, Martínez, G, Garcia, M, Carreño, G, Cifuentes, J, Monzón, J, Maseda, O, Huerga, D, Pavel, C, Gris, F, Segura, I, Palma, P, Díaz, JG, Jiménez, JL, Pérez, F, Portugal, V, Bernal, JC, Lluis, F, Capitán, L, Cáceres, N, Martínez, J, Estévez, A, Maestre, MV, Díaz, JM, Reig, M, Amaya, A, Carmona, JA, Jiménez, FJ, Serrat, DR, Prieto, I, Garcia, D, De Francisco, TG, Turienzo, A, Martinez, M, Del Valle, S, Parra, P, Romero, F, Garcea, A, O De La, XR, Pérez, A, Ais, G, De Zarate, LO, Sánchez, J, Estevan, R, Sueiras, A, Lamiquiz, A, Larzabal, A, Die, J, Solana, A, Blanco, FJ, Ma Lage, A, Domínguez, JL, Dujovne, P, Palencia, N, García, R, Adell, R, Martínez, R, Ma Huidobro, A, Pastor, C, Garijo, J, Carrillo, Á, De La Vega, MDC & López, M 2014, 'Multicenter study of outcome in relation to the type of resection in rectal cancer', Diseases of the Colon and Rectum, vol. 57, núm. 7, pàg. 811-822. https://doi.org/10.1097/DCR.0000000000000026

TY - JOUR

T1 - Multicenter study of outcome in relation to the type of resection in rectal cancer

AU - Ortiz, Hector

AU - Wibe, Arne

AU - Ciga, Miguel Angel

AU - Kreisler, Esther

AU - Garcia-Granero, Eduardo

AU - Roig, Jose Vicente

AU - Biondo, Sebastiano

AU - Lujan, Juan

AU - Fraccalvieri, Doménico

AU - Armendáriz, Pedro

AU - De Miguel, Mario

AU - Espí, Alejandro

AU - Codina, Antonio

AU - Ruiz, María D.

AU - Espin, Eloy

AU - Palasí, Rosana

AU - Parajo, Alberto

AU - Camps, Ignasi

AU - Piñol, Marta

AU - Pellicer, Enrique

AU - Viciano, Vicent

AU - Alonso, Evelio

AU - Pera, Miguel

AU - García, Teresa

AU - Casal, Enrique

AU - Garcia, Jacinto

AU - Rodríguez, Marcos

AU - Reina, Ángel

AU - Errasti, José

AU - Múgica, José A.

AU - Gomez, José

AU - Rada, Ricardo

AU - Orelogio, Mónica

AU - Uribe, Natalia

AU - De Dios Franco, Juan

AU - Arroyo, Antonio

AU - Sierra, José Enrique

AU - Hernandez, Pilar

AU - Paredes, Jesús

AU - Martínez, Gabriel

AU - Garcia, Mauricio

AU - Carreño, Guillermo

AU - Cifuentes, Jesús

AU - Monzón, José

AU - Maseda, Olga

AU - Huerga, Daniel

AU - Pavel, Calin

AU - Gris, Fernando

AU - Segura, Inmaculada

AU - Palma, Pablo

AU - Díaz, José Gregorio

AU - Jiménez, José Luis

AU - Pérez, Francisco

AU - Portugal, Vicente

AU - Bernal, Juan C.

AU - Lluis, Félix

AU - Capitán, Luis

AU - Cáceres, Nieves

AU - Martínez, Javier

AU - Estévez, Alfredo

AU - Maestre, María Victoria

AU - Díaz, José Manuel

AU - Reig, Mónica

AU - Amaya, Antonio

AU - Carmona, José Antonio

AU - Jiménez, Francisco J.

AU - Serrat, Dídac Ribéi

AU - Prieto, Isabel

AU - Garcia, Damian

AU - De Francisco, Tomas González

AU - Turienzo, Amor

AU - Martinez, Manuel

AU - Del Valle, Sergio

AU - Parra, Pedro

AU - Romero, Francisco

AU - Garcea, Alessandro

AU - O De La, Xavier Rodamilans

AU - Pérez, Alberto

AU - Ais, Guillermo

AU - De Zarate, Luis Ortiz

AU - Sánchez, Jesús

AU - Estevan, Rafael

AU - Sueiras, Albert

AU - Lamiquiz, Alberto

AU - Larzabal, Andoni

AU - Die, Javier

AU - Solana, Amparo

AU - Blanco, Francisco Javier

AU - Ma Lage, Ana

AU - Domínguez, José L.

AU - Dujovne, Paula

AU - Palencia, Natividad

AU - García, Rafael

AU - Adell, Raul

AU - Martínez, Roberto

AU - Ma Huidobro, Ana

AU - Pastor, Carlos

AU - Garijo, Jesús

AU - Carrillo, Ángel

AU - De La Vega, Ma Del Coral

AU - López, Manuel

PY - 2014

Y1 - 2014

N2 - BACKGROUND: A surgical teaching and auditing program has been implemented to improve the results of treatment for patients with rectal cancer. OBJECTIVE: The aim of this study was to assess the treatment and outcome in patients resected for rectal cancer, focusing on differences relating to the type of resection. DESIGN: This was an observational study. SETTINGS: The study took place throughout the network of hospitals that compose the National Health Service in Spain. PATIENTS: This study included a consecutive cohort of 3355 patients from the Spanish Rectal Cancer Project. The data of patients who were operated on electively, with curative intent, by anterior resection (n = 2333 [69.5%]), abdominoperineal excision (n = 774 [23.1%]), and Hartmann procedure (n = 248 [7.4%]) between March 2006 and May 2010 were analyzed. MAIN OUTCOME MEASURES: Clinical, pathologic, and outcome results were analyzed in relation to the type of surgery performed. RESULTS: After a median follow-up time of 37 months (interquartile range, 30-48 months), bowel perforations were found to be more common in the Hartmann procedure (12.6%) and abdominoperineal groups (10.1%) than in the anterior resection group (2.3%; p < 0.001). Involvement of the circumferential resection margin was also more common in the Hartmann (16.6%) and abdominoperineal groups (14.3%) than in the anterior resection group (6.6%; p < 0.001). Multivariate analysis showed a negative influence on local recurrence, metastasis, survival for advanced stage, intraoperative perforation, invaded circumferential margin, and Hartmann procedure. However, abdominoperineal excision did not significantly influence local recurrence (HR, 0.945; 95% CI, 0.571- 1.563; p = 0.825). LIMITATIONS: The main weakness of this study was the voluntary nature of registration in the Spanish Rectal Cancer Project. CONCLUSIONS: Although bowel perforation and involvement of the circumferential resection margin were more common after abdominoperineal excision than after anterior resection, this study did not identify abdominoperineal excision as a determinant of local recurrence in the context of 3 years of median follow-up.

AB - BACKGROUND: A surgical teaching and auditing program has been implemented to improve the results of treatment for patients with rectal cancer. OBJECTIVE: The aim of this study was to assess the treatment and outcome in patients resected for rectal cancer, focusing on differences relating to the type of resection. DESIGN: This was an observational study. SETTINGS: The study took place throughout the network of hospitals that compose the National Health Service in Spain. PATIENTS: This study included a consecutive cohort of 3355 patients from the Spanish Rectal Cancer Project. The data of patients who were operated on electively, with curative intent, by anterior resection (n = 2333 [69.5%]), abdominoperineal excision (n = 774 [23.1%]), and Hartmann procedure (n = 248 [7.4%]) between March 2006 and May 2010 were analyzed. MAIN OUTCOME MEASURES: Clinical, pathologic, and outcome results were analyzed in relation to the type of surgery performed. RESULTS: After a median follow-up time of 37 months (interquartile range, 30-48 months), bowel perforations were found to be more common in the Hartmann procedure (12.6%) and abdominoperineal groups (10.1%) than in the anterior resection group (2.3%; p < 0.001). Involvement of the circumferential resection margin was also more common in the Hartmann (16.6%) and abdominoperineal groups (14.3%) than in the anterior resection group (6.6%; p < 0.001). Multivariate analysis showed a negative influence on local recurrence, metastasis, survival for advanced stage, intraoperative perforation, invaded circumferential margin, and Hartmann procedure. However, abdominoperineal excision did not significantly influence local recurrence (HR, 0.945; 95% CI, 0.571- 1.563; p = 0.825). LIMITATIONS: The main weakness of this study was the voluntary nature of registration in the Spanish Rectal Cancer Project. CONCLUSIONS: Although bowel perforation and involvement of the circumferential resection margin were more common after abdominoperineal excision than after anterior resection, this study did not identify abdominoperineal excision as a determinant of local recurrence in the context of 3 years of median follow-up.

KW - Abdominoperineal resection

KW - Local recurrence

KW - Metastases

KW - Overall survival

KW - Rectal cancer

UR - http://www.scopus.com/inward/record.url?scp=84904670911&partnerID=8YFLogxK

U2 - 10.1097/DCR.0000000000000026

DO - 10.1097/DCR.0000000000000026

M3 - Article

C2 - 24901681

AN - SCOPUS:84904670911

SN - 0012-3706

VL - 57

SP - 811

EP - 822

JO - Diseases of the Colon and Rectum

JF - Diseases of the Colon and Rectum

IS - 7

ER -

Multicenter study of outcome in relation to the type of resection in rectal cancer

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