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Sex differences between cT4b and pT4b rectal cancers.

Koji Komori1, Kenya Kimura, Takashi Kinoshita

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Female rectal cancer patients more frequently required extensive surgery for adjacent organ invasion compared to males. While survival rates were similar, females experienced higher local recurrence rates, necessitating tailored surgical approaches.

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Sex Differences in Medicine

Background:

  • Rectal cancer frequently invades adjacent organs, complicating surgical management.
  • Understanding sex-based differences in advanced rectal cancer is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To investigate sex differences in pathological findings of rectal cancer with adjacent organ invasion.
  • To evaluate the impact of sex on surgical extent and outcomes in these cases.

Main Methods:

  • Retrospective analysis of 61 consecutive rectal cancer patients undergoing curative surgery with resection of invaded adjacent organs.
  • Comparison of pathological findings, surgical extent, and recurrence rates between male and female patients.

Main Results:

  • Females (46.9%) were significantly more likely than males (13.8%) to require resection of more than two adjacent organs (P = 0.006).
  • Histopathologic invasion was observed in 28.1% of females versus 13.8% of males (P = 0.08).
  • Overall survival did not differ significantly by sex, but local recurrence was more common in females.

Conclusions:

  • Sex is a significant factor influencing the extent of surgery required for rectal cancer invading adjacent organs.
  • While survival may be comparable, increased local recurrence in females suggests a need for sex-specific treatment considerations.
  • Careful assessment of invasion and tailored surgical planning are essential for managing rectal cancer with adjacent organ involvement.