Short- and Long-term Outcomes After Curative Surgery for Rectal Cancer in Patients Under the Age of Fourty Years: A Stage Based Case-match Analysis
Journal Title: Istanbul Medical Journal - Year 2020, Vol 21, Issue 2
Abstract
Introduction: The aim of the study is to compare the short and long-term outcomes after curative surgery for rectal cancer in patients under the age of 40 years and over the age of 50 years. Methods: A total of 46 patients with rectal cancer were retrieved from a prospectively designed database after the exclusion of stage 4 cases (<40 group). A case-match group (1:2) at similar stage was created among patients over 50 years of age (>50 group, n=92). Demographics, perioperative information, and oncological and pathological results were compared between the groups. The primary outcome measure was 5 year survival. Results: The numbers of male cases were similar (59% vs 52%, p=0.468) between the groups. There were more patients who received preoperative radiation (98% vs 71%, p<0.001) in <40 group related to the location of the tumor and intolerance to the treatment. The tumors were closer to the dentate line [3 (0-15) cm vs 5 (0-15) cm, p=0.006)] and the rate of abdominoperineal resection was higher (39% vs 22%, p=0.031) in <40 group. Laparoscopy (72% vs 85%, p=0.069), conversion to open surgery (7% vs 10%), p=0.751), operation time (224±57 min vs 210±62 min, p=0.226), intraoperative bleeding [200 (10-1300) mL vs 200 (10-1500) mL, p=0.514], requirement of perioperative transfusion (30% vs 27%, p=0.688), reoperation (2% vs 2%, p=0.999) and 30 day mortality (2% vs 1%, p=0.333) rates, hospitalization period [7 (4-49) vs 7 (2-47) days, p=0.25] were similar. Tumor differentiation was poorer (p=0.046) in <40 group, but other pathological parameters were similar between the groups: number of harvested lymph nodes [14 (0-53) vs 12 (0-43), p=0172], number of malignant lymph nodes [1 (0-29) vs 1(0-11), p=0.616] and invasion rates [(0.09 0-0.93) vs 0.07(0-0.82), p=0.762]. Kaplan-Meier analysis revealed similar 5 year survival rates (63% vs 60%, p=0.052). Conclusion: When similar tumor stages are considered, the survival is similar in rectal cancer patients below the age of 40 years and over the age of 50 years.
Authors and Affiliations
Osman Civil, Mustafa Öncel
Keywords
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- EP ID EP685072
- DOI 10.4274/imj.galenos.2020.33339
- Views 110
- Downloads 0
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