Do Patients Needing a Multivisceral Resection for Rectal Cancer Have Worse Oncologic Outcomes than Patients Undergoing Only APR?

Q: Do patients needing a multivisceral resection for rectal cancer have worse oncologic outcomes than patients undergoing only abdominoperineal resection (APR)?

A: We know that advanced cancers sometimes invade other structures and we have to, as part of a good oncological operation, resect other organs.

The goal of a recent study in the American Journal of Surgery was to see if there are worse oncological outcomes or overall outcomes depending on the approach — whether only the rectum is removed, or the rectum and other organs.

What we found was that by adhering to proper oncological operations, both APR and multivisceral resections can be safely performed with low morbidity and without compromising any overall cancer outcomes.

There’s no question that when patients undergo multivisceral resection, in general, there is a trend toward lower overall survival, but we found their oncological outcomes are similar.

The take-home point? Advanced tumors often times are in sicker people, or they have more going on and their overall survival may change. But our study found that if you followed good cancer surgery principles, their cancer outcomes are pretty much equivalent.

— Scott R. Steele, MD
Chairman, Colorectal Surgery