İstanbul Medical Journal (Mar 2020)

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

  • Osman Civil,
  • Mustafa Öncel

DOI
https://doi.org/10.4274/imj.galenos.2020.33339
Journal volume & issue
Vol. 21, no. 2
pp. 126 – 131

Abstract

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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 (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.

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