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Total mesorectal excision for surgical treatment of rectal cancer
A Bolognese1, M Cardi, I A Muttillo
1Department of Surgery "Pietro Valdoni" C.I.M.S., Policlinico Umberto I, University of Rome "La Sapienza," Rome, Italy. bol.clch@tiscalinet.it
Background And Objectives:
The aim of our study was to retrospectively evaluate the results of 2 groups of patients admitted and treated for rectal cancer.
Methods:
One hundred and fifty-one patients were available for evaluation. Eighty (group A) were radically operated with the standard technique; 71 (group B) underwent total mesorectal excision (TME). Groups were similar according to demographics, staging, and pathological data. Mean follow-up was 73.5 months.
Results:
No operative mortality was observed. Complications were 15% in group A and 32% in group B. Local recurrence rates were 41.2% in group A and 12.6% in group B. Distant metastases occurred in 21.2% and 7.6%, respectively, in groups A and B. Cancer-related mortality was 62.5% in the non-TME group and 19.5% in the TME group. Overall 5-year survival rates were 32.4% in group A and 70.5% in group B. Disease-free survival rates were 25% in group A and 62.3% in group B.
Conclusions:
TME appears to lower the incidence of cancer-related mortality, with a higher incidence of postoperative complications. Further studies need to be done to assess the real benefits of TME in the surgical treatment of rectal cancer.