Carcinoma of the rectum: Treatment by anterior resection or abdominoperineal excision?

Abstract

Summary From 1,007 patients treated for carcinoma of the rectum from 1950 to 1964, 153 with carcinomas 11-15 cm from the anal verge were selected. There was no random selection, but 70 of the patients were treated by anterior resection, and 83 by abdomino-perineal excision. The two groups were reasonably comparable with reference to Dukes' classification, tumor size, age, and complicating diseases. There were slightly higher proportions of carcinomas invading local organs, colloid carcinomas, and anaplastic neoplasms in the abdominoperineal excision group. Postoperative mortality rates (7 and 8 per cent) and incidences of complications were much the same in the two groups. The corrected five- and ten-year survival rates, respectively, were 78.8 and 57.4 per cent in the anterior resection group and 65 and 46.6 per cent in the abdomino-perineal excision group. We conclude that it is justifiable to perform anterior resection in treatment of patients with carcinomas of the rectum of Dukes' types B and C when the carcinomas are more than 10 cm from the anal verge.