Recurrence and survival after abdominoperineal and low anterior resection for rectal cancer, without adjunctive therapy

Sphincter-saving operations for rectal cancer are performed with increasing frequency. In the present study outcome after low anterior resection (LAR) was compared with outcome after abdominoperineal resection (APR). Morbidity, mortality, local and distant failure and survival were retrospectively studied in 68 patients, surgically treated for rectal cancer without adjunctive therapy between 1980 and 1985. APR was performed in 29 patients (27 for cure) and LAR in 39 (32 for cure). Mean follow-up time was 60 months (range 39-95 months). Groups were comparable with regard to age and Dukes' staging, but not for location of the tumour. Anastomotic leakage was present in 15% after LAR; morbidity was otherwise similar in both groups. Hospital mortality was 5% after LAR and 0% after APR. Local recurrence occurred after a mean period of 17 months: in 15% after curative APR and in 13% after curative LAR. Distant recurrence was detected after a mean period of 28 months: in 30% after curative APR and in 26% after curative LAR. Estimated cumulative 5-year survival was not statistically different, with 72% after LAR and 59% after APR. These findings confirm that LAR does not lead to higher recurrence than APR in the treatment for rectal cancer.