Description

den Dulk et al identified a number of risk factors for adverse outcomes in a patient with rectal cancer treated with an abdominoperineal resection. This can help to identify a patient who may benefit from more aggressive management or an alternative therapy. The authors are from Leiden University, Catherina Hospital Eindhoven, University Hospital Maastricht, University Medical Center Groningen and the Dutch Colorectal Cancer Group.


 

Patient selection: rectal cancer S/P abdominoperineal resection following preoperative radiotherapy

 

Risk factors for a positive circumferential resection margin:

(1) female gender

(2) tumor on the anterior wall of the rectum

(3) T3 or T4 stage

(4) N2 stage (metastases in >= 4 nodes)

 

Risk factors associated with worse overall survival:

(1) age >= 50 years (odds ratio 2 for 50-70 years, 3 for > 70 years)

(2) T3 or T4 stage

(3) N2 stage (metastases in >= 4 nodes)

(4) positive circumferential margin

(5) tumor < 2 cm from anal verge

 


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