A multidisciplinary approach to rectal cancer decreases frequency of abdominoperineal resections.
- Author:
Marc Paul J LOPEZ
;
Manuel Francisco T ROXAS
;
Marie Dione A. PARREÑO-SACDALAN
;
Mark Francis A MELENDRES
;
Hermogenes J MONROY III
;
Armando C CRISOSTOMO
;
Alberto B. ROXAS
;
Up-pgh Colorectal Cancer And POLYP STUDY GROUP
- Publication Type:Journal Article, Original
- Keywords: Abdominoperineal ResectionAbdominoperineal ExcisionSphincter-saving SurgeryRectal CancerCancer Of Rectum
- MeSH: Human; Aged 80 And Over; Aged; Middle Aged; Colorectal Neoplasms; Hospitals, General; Philippines; Rectal Neoplasms; Rectum; Chemoradiotherapy; Digestive System Surgical Procedures; Patient Care Team
- From: Philippine Journal of Surgical Specialties 2010;65(3):105-110
- CountryPhilippines
- Language:English
-
Abstract:
For so many years, abdominoperineal excision has been the mainstay of surgical treatment for rectal cancer 7 cm and below the anal verge. With continued research and introduction of new technology, the management of rectal malignancies has involved making it possible to save the sphincter complex mechanism despite the distance from the verge. Concurrent with these developments is the introduction of a multidisciplinary team approach which the UP-Philippine General Hospital Colorectal Division has adopted in managing colorectal cancer cases. With the adoption of these advancements in the management of patients with rectal cancer, it is surmised that the institution's APR rates have decreased.
OBJECTIVES: The study aimed to document and compare the abdominoperineal resection (APR) rates at the Philippine General Hospital (PGH), before and after the introduction of a multidisciplinary team for colorectal cancer, over the course of 5 years (2005-2009).
METHODS: The study included all adult patients undergoing resection for low to mid rectal cancer, described as a tumor with distal extent of 11 cm or below from the anal verge (FAV), from January 1, 2005 to December 31, 2009. Data pertinent to the management were gathered. Frequencies and rates before and after the introduction of a multidisciplinary team approach were computed and compared.
RESULTS: There were a total of 230 rectal resection for cancer over a five-year period. The patients' mean age was 53 years (range: 26 to 83). There were 122 males and 108 females. Almost half of the patients (48.7%) presented with a clinical stage of Stage IIIB. Forty-three percent of patients underwent either pre-operative radiotherapy or combined chemoradiotherapy. Cumulatively, the APR rate was 30.90 percent (sphincter-saving rate 69.10%) The APR rate for 2009 was 12.82 percent (sphincter-saving rate 87.18) corresponding to a 39.18 percent decrease in APR rate from the highest APR rate recorded in 2006 (52%).
CONCLUSION: A multidisciplinary team (MDT) approach resulted in lower APR rates among patients with rectal cancer at the UP-PGH.