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JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. VI, n 1, June 2019

Pages: 627-635
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Predictive Factors of Oncological and Survival Outcome of Surgery on Mid and Low Rectal Adenocarcinoma in Morocco :Single Center Study

Author: H. Essangri, MA. Majbar, A.Benkabbou, L. Amrani, Z.Belkhadir, A. Ghennam, B. Al Ahmadi, A. Bougtab, R. Mohsine, A.Souadka

Category: JMSR Oncology

Abstract:

Introduction: The aim of our study is to assess the 3 years oncological outcomes (survival rates and predictive factors of impaired Overall survival) in low rectal cancer patients operated with curative intent in the National Oncology Institute of Rabat.

Patients and methods: We conducted a retrospective study, including all patients operated for low rectal cancer in the surgical department of the national oncology institute of Rabat from January 2011 to December 2015. Preoperative characteristics, clinical and pathological variables including the histological type, the grade of tumor and TNM staging as well as perioperative and postoperative outcomes were recorded and analyzed to determine the predictive factors of imaired overall survival using cox regression and Kaplan Meier representation

.Results: In 81 low rectal adenocarcinoma operated in this period, the average survival period was of 55. 8 months. The Overall survival rate after 1 year, 2 years and 3 years are respectively of 94%, 89. 1%, and 82. 8%. Predictive factors of impaired survival were age and advanced tumor staging with respectively a HR: 3.5; 95CI:1.1-11.4; p=0.03 and HR: 3.9 95CI:1.2-12.4; p=0.01.

Conclusion: This study showed survival rates after curative surgery for low rectal adenocarcinoma similar to those reported in the literature. Independent factors associated with overall survival were high age and advanced T stage, highlighting the importance of early cancer detection particularly in elderly subjects in order to improve the overall survival in rectal cancer Moroccan patients.

Keywords: Disease free survival, Overall survival, Predictive factors, Rectal cance, Recurrence

References:

  1. Casablanca G. Registre Des Cancers de la Région du Grand Casablanca pour la période. 2008.
  2. Tazi MA, Benjaafar N, Er-Raki A. Incidence des cancers à Rabat 2005. 2009; 84.
  3. El Hilali H, El Hilali F, Samih M, Laziri F. Cancer incidence in northern central Moroccan patients. Journal of Medical and Surgical Research (JMSR) 2017; IV: 403- 9.
  4. Globocan. Colorectal cancer Source: Globocan 2018 Number of new cases in 2018, both sexes, all ages. 2018; 876: 1–2. Available from: http://gco.iarc.fr/today
  5. Lirici MM, Hüscher CGS. Techniques and technology evolution of rectal cancer surgery: a history of more than a hundred years. Minimally Invasive Therapy and Allied Technologies. 2016.
  6. No I, Background I, Study OM, Participants S, Data V, Study B, et al. STROBE Statement—Checklist of items that should be included in reports of. (1):1–2.
  7. Schmidt E, Bruch HP. Autotransplantation of smooth muscle for treating incontinence of sphincters. J Chir (Paris). 1981;
  8. Souadka A, Majbar MA, El Harroudi T, Benkabbou A, Souadka A. Perineal pseudocontinent colostomy is safe and efficient technique for perineal reconstruction after abdominoperineal resection for rectal adenocarcinoma. BMC Surg. 2015;
  9. Dworak O, Keilholz L, Hoffmann A. Pathological features of rectal cancer after preoperative radiochemotherapy. Int J Colorectal Dis. 1997;
  10. Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikši? M, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37?513?025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;
  11. Sankaranarayanan R, Swaminathan R, Jayant K, Brenner H. An overview of cancer survival in Africa, Asia, the Caribbean and Central America: the case for investment in cancer health services. IARC Sci Publ. 2011;
  12. Kotake K, Asano M, Ozawa H, Kobayashi H, Sugihara K. Gender differences in colorectal cancer survival in Japan. Int J Clin Oncol. 2016;
  13. Xiao Y, Wu B, Qiu H, Xiong G, Lin G, Zhong G, et al. [Effects of tumor distance from anal verge and types of operations on survival outcomes for low rectal cancer after neoadjuvant chemoradiotherapy]. Zhonghua Yi Xue Za Zhi. 2014;
  14. Das P, Skibber JM, Rodriguez-Bigas MA, Feig BW, Chang GJ, Hoff PM, et al. Clinical and pathologic predictors of locoregional recurrence, distant metastasis, and overall survival in patients treated with chemoradiation and mesorectal excision for rectal cancer. Am J Clin Oncol Cancer Clin Trials. 2006;
  15. Wang CB, Shahjehan F, Merchea A, Li Z, Bekaii-Saab TS, Grothey A, et al. Impact of Tumor Location and Variables Associated With Overall Survival in Patients With Colorectal Cancer: A Mayo Clinic Colon and Rectal Cancer Registry Study. Front Oncol. 2019;
  16. Ong MLH, Schofield JB. Assessment of lymph node involvement in colorectal cancer. World J GastroIntest Surg. 2016;
  17. Liu Q, Luo D, Cai S, Li Q, Li X. Circumferential resection margin as a prognostic factor after rectal cancer surgery: A large population-based retrospective study. Cancer Med. 2018;
  18. Nagtegaal ID, Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? Journal of Clinical Oncology. 2008.
  19. Majbar M.A., El alaoui M, Raiss M, Sabbah F, Hrora A. Intersphincteric resection for rectal adenocarcinoma?: technique, indications, and results.. Journal of Medical and Surgical Research (JMSR) 2014; I (1): 24- 27.
  20. Delaney CP, Lavery IC, Brenner A, Hammel J, Senagore AJ, Noone RB, et al. Preoperative radiotherapy improves survival for patients undergoing total mesorectal excision for stage T3 low rectal cancers. Ann Surg. 2002;
  21. Nowakowski M, Pisarska M, Rubinkiewicz M, Torbicz G, Gajewska N, Mizera M, et al. Postoperative complications are associated with worse survival after laparoscopic surgery for non-metastatic colorectal cancer – interim analysis of 3-year overall survival. Videosurgery Other Mini-invasive Tech. 2018;
  22. Papamichael D, Audisio RA, Glimelius B, de Gramont A, Glynne-Jones R, Haller D, et al. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013. Annals of Oncology. 2015.
  23. Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: Results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012;
  24. Roman S, Cenni JC, Roy P, Pujol B, Napoleon B, Keriven-Souquet O, et al. Value of rectal ultrasound in predicting staging and outcome in patients with rectal adenocarcinoma. Dis Colon Rectum. 2004;
  25. Abdalmassih M, Sivananthan G, Raizman Z, Lambert P, Wirtzfeld D, Bashir B, et al. Prognostic markers of recurrence and survival in rectal cancer treated with neoadjuvant chemoradiotherapy and surgery. Color Cancer. 2018;
  26. Longo WE, Johnson FE. The preoperative assessment and postoperative surveillance of patients with colon and rectal cancer. Vol. 82, Surgical Clinics of North America. 2002. p. 1091–108.
  27. McCall JL, Black RB, Rich CA, Harvey JR, Baker RA, Watts JM, et al. The value of serum carcinoembryonic antigen in predicting recurrent disease following curative resection of colorectal cancer. Dis Colon Rectum. 1994; 37(9):875–81.