SURVIVAL AFTER PERANAL AND ABDOMINOPERINEAL RESECTION FOR RECTAL-CARCINOMA

The outcome of a consecutive series of 47 patients with rectal cancer treated by endoscopic transanal resection or peranal local excision wa s contrasted with that of 42 patients undergoing abdominoperineal rese ction. Surgery was considered curative for 35 and nine patients treate d by abdominoperineal and peranal resection respectively (P<0.001). Pa tients undergoing peranal excision were older than those treated by ab dominoperineal resection(median 77 versus 69 years, P<0.01). The 5-yea r survival rate of patients undergoing peranal resection was 24 per ce nt compared with 33 per cent for those treated by the abdominoperineal procedure (P<0.005). When surgery was palliative the survival rate af ter both procedures was the same. Survival after peranal excision was significantly poorer than that after abdominoperineal resection but th is may be acceptable when the stage of disease and age of the patients are taken into account.