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Cited 6 time in webofscience Cited 7 time in scopus
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Risk factors for local recurrence and long term survival after minimally invasive intersphincteric resection for very low rectal cancer: Multivariate analysis in 161 patients

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dc.contributor.authorPiozzi, G.N.-
dc.contributor.authorPark, H.-
dc.contributor.authorLee, T.H.-
dc.contributor.authorKim, Ji Sean-
dc.contributor.authorChoi, H.B.-
dc.contributor.authorBaek, S.J.-
dc.contributor.authorKwak, J.M.-
dc.contributor.authorKim, J.-
dc.contributor.authorKim, S.H.-
dc.date.accessioned2021-06-14T01:40:08Z-
dc.date.available2021-06-14T01:40:08Z-
dc.date.issued2021-08-
dc.identifier.issn0748-7983-
dc.identifier.issn1532-2157-
dc.identifier.urihttps://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/52927-
dc.description.abstractIntroduction: Intersphincteric resection (ISR) is the ultimate anal-sparing technique as an alternative to abdominoperineal resection in selected patients. Oncological safety is still debated. This study analyses long-term oncological results and evaluates risk factors for local recurrence (LR) and overall survival (OS) after minimally-invasive ISR. Materials and methods: Retrospective single-center data were collected from a prospectively maintained colorectal database. A total of 161 patients underwent ISR between 2008 and 2018. OS and local recurrence-free survival (LRFS) were assessed using Kaplan-Meier analysis (log-rank test). Risk factors for OS and LRFS were assessed with Cox-regression analysis. Results: Median follow-up was 55 months. LR occurred in 18 patients. OS and LRFS rates at 1, 3, and 5 years were 96%, 91%, and 80% and 96%, 89%, and 87%, respectively. Tumor size (p = 0.035) and clinical T-stage (p = 0.029) were risk factors for LRFS on univariate analysis. On multivariate analysis, tumor size (HR 2.546 (95% CI: 0.976–6.637); p = 0.056) and clinical T-stage (HR 3.296 (95% CI: 0.941–11.549); p = 0.062) were not significant. Preoperative CEA (p < 0.001), pathological T-stage (p = 0.033), pathological N-stage (p = 0.016) and adjuvant treatment (p = 0.008) were prognostic factors for OS on univariate analysis. Preoperative CEA (HR 4.453 (95% CI: 2.015–9.838); p < 0.001) was a prognostic factor on multivariate analysis. Conclusions: This study confirms the oncological safety of minimally-invasive ISR for locally advanced low-lying rectal tumors when performed in experienced centers. Despite not a risk factor for LR, tumor size and, locally advanced T-stage with anterior involvement should be carefully evaluated for optimal surgical strategy. Preoperative CEA is a prognostic factor for OS. © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology-
dc.format.extent9-
dc.language영어-
dc.language.isoENG-
dc.publisherW.B. Saunders Ltd-
dc.titleRisk factors for local recurrence and long term survival after minimally invasive intersphincteric resection for very low rectal cancer: Multivariate analysis in 161 patients-
dc.typeArticle-
dc.publisher.location영국-
dc.identifier.doi10.1016/j.ejso.2021.03.246-
dc.identifier.scopusid2-s2.0-85103404267-
dc.identifier.wosid000723107300035-
dc.identifier.bibliographicCitationEuropean Journal of Surgical Oncology, v.47, no.8, pp 2069 - 2077-
dc.citation.titleEuropean Journal of Surgical Oncology-
dc.citation.volume47-
dc.citation.number8-
dc.citation.startPage2069-
dc.citation.endPage2077-
dc.type.docTypeArticle; Early Access-
dc.description.isOpenAccessN-
dc.description.journalRegisteredClassscie-
dc.description.journalRegisteredClassscopus-
dc.relation.journalResearchAreaOncology-
dc.relation.journalResearchAreaSurgery-
dc.relation.journalWebOfScienceCategoryOncology-
dc.relation.journalWebOfScienceCategorySurgery-
dc.subject.keywordPlusCOLOANAL ANASTOMOSIS-
dc.subject.keywordPlusOUTCOMES-
dc.subject.keywordPlusSURGERY-
dc.subject.keywordAuthorAnal sparing surgery-
dc.subject.keywordAuthorIntersphincteric resection-
dc.subject.keywordAuthorMinimally invasive surgery-
dc.subject.keywordAuthorPelvic local recurrence-
dc.subject.keywordAuthorRectal cancer-
dc.subject.keywordAuthorRobotic surgery-
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Anam Hospital (Department of Colon and Rectal Surgery, Anam Hospital)
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