ABDOMINOPERINEAL RESECTION AND ANTERIOR RESECTION IN THE TREATMENT OFRECTAL-CANCER - RESULTS IN RELATION TO ADJUVANT PREOPERATIVE RADIOTHERAPY

The outcome of patients with rectal cancer treated by abdominoperineal or anterior resection, with or without preoperative radiotherapy, was assessed to detect any differences attributable to the operative meth od and interactions between radiotherapy and type of surgery. The stud y was based on 1292 patients in two consecutive controlled randomized trials of preoperative radiotherapy in operable rectal carcinoma. The outcome was not related to surgical method. Radiotherapy increased pos toperative mortality and complications and reduced local and distant r ecurrence, but had no effect on overall survival. Effects of radiother apy were similar irrespective of the type of surgery, except that the increase in postoperative mortality in irradiated patients was greater in those treated with abdominoperineal resection. Sphincter-savings p rocedures appear to have no adverse effects on outcome of rectal cance r, but the optimum use of radiotherapy is still to be defined.