Objective: To compare clinical efficacy between abdominoperineal resection (APR) procedure and anterior resection(AR) procedure in patients with rectal cancer.
Methods: Clinicopathological data of 309 cases with rectal cancer undergoing resection in Peking University People's Hospital from January 1998 to December 2012 were retrospectively analyzed. Short-term outcomes, local recurrence, overall survival (OS) and progression-free survival (PFS) were investigated between two groups.
Results: As compared to the AR group, the operative time was longer [(268.5 ± 66.7) min vs. (247.4 ± 64.2) min, P=0.005], blood loss[(668.5 ± 680.1) ml vs.(441.8 ± 478.6) ml, P=0.001] and drainage volume were more[(66.9 ± 54.7) ml vs. (49.0 ± 45.9) ml, P=0.002] in the APR group. There was no significant difference of local recurrence between the two groups, while the 5-year local recurrence rate of T3-T4 patients undergoing APR procedure (24.9%) was higher than that of AR group (13.9%)(P=0.038), especially in the patients with tumors located at 4-6 cm away from the anus verge. There were no significant differences of OS (P=0.273) and PFS (P=0.589) between two groups, while both 5-year OS and PFS of T3-T4 patients with BMI ≥ 24 undergoing APR procedure (43.1% and 42.8%) were significantly worse than those of patients undergoing AR procedure (87.9% and 76.9%, P=0.022 and P=0.041).
Conclusions: The overall prognosis of patients after APR and AR is comparable. Tumor located at 4-6 cm away from the anus verge, T3-T4 stage, obese may play an important role in the worse prognosis of the patients undergoing APR procedure.