Advanced

The importance of rectal washout for the oncological outcome after Hartmann’s procedure for rectal cancer : analysis of population-based data from the Swedish Colorectal Cancer Registry

Jörgren, F. LU ; Johansson, R.; Arnadottir, H. and Lindmark, G. LU (2017) In Techniques in Coloproctology 21(5). p.373-381
Abstract

Background: During rectal cancer surgery the bowel may contain viable, exfoliated cancer cells, a potential source for local recurrence (LR). The amount and viability of these cells can be reduced using intraoperative rectal washout, a procedure that reduces the LR risk after anterior resection. The aim of this study was to analyse the impact of washout on oncological outcome when performed in Hartmann’s procedure (HP) for rectal cancer. Methods: A national cohort study on data for patients registered from 1995 to 2007 in the Swedish Colorectal Cancer Registry was carried out. The final analysis included patients belonging to TNM stages I–III who had undergone R0 HP with a registered 5-year follow-up. Multivariate analysis was... (More)

Background: During rectal cancer surgery the bowel may contain viable, exfoliated cancer cells, a potential source for local recurrence (LR). The amount and viability of these cells can be reduced using intraoperative rectal washout, a procedure that reduces the LR risk after anterior resection. The aim of this study was to analyse the impact of washout on oncological outcome when performed in Hartmann’s procedure (HP) for rectal cancer. Methods: A national cohort study on data for patients registered from 1995 to 2007 in the Swedish Colorectal Cancer Registry was carried out. The final analysis included patients belonging to TNM stages I–III who had undergone R0 HP with a registered 5-year follow-up. Multivariate analysis was performed. Results: A total of 1188 patients were analysed (686 washout and 502 no washout). No differences were detected between the washout group and the no washout group concerning rates of LR [7% (49/686) vs. 10% (49/502); p = 0.13], distant metastasis (DM) [17% (119/686) vs. 18% (93/502); p = 0.65], and overall recurrence (OAR) [21% (145/686) vs. 24% (120/502); p = 0.29]. For both groups, the 5-year cancer-specific survival was below 50%. In multivariate analysis, washout neither decreased the risk of LR, DM, or OAR nor increased overall or the cancer-specific 5-year survival. Conclusions: The oncological outcome did not improve when washout was performed in HP for rectal cancer.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Hartmann’s procedure, Rectal cancer, Rectal washout, Recurrence, Survival
in
Techniques in Coloproctology
volume
21
issue
5
pages
9 pages
external identifiers
  • scopus:85019678971
  • wos:000403535800006
ISSN
1123-6337
DOI
10.1007/s10151-017-1637-5
language
English
LU publication?
yes
id
7adcbd9d-08fb-42c7-b75e-5dc83d488166
date added to LUP
2017-06-21 14:47:45
date last changed
2017-09-21 03:00:03
@article{7adcbd9d-08fb-42c7-b75e-5dc83d488166,
  abstract     = {<p>Background: During rectal cancer surgery the bowel may contain viable, exfoliated cancer cells, a potential source for local recurrence (LR). The amount and viability of these cells can be reduced using intraoperative rectal washout, a procedure that reduces the LR risk after anterior resection. The aim of this study was to analyse the impact of washout on oncological outcome when performed in Hartmann’s procedure (HP) for rectal cancer. Methods: A national cohort study on data for patients registered from 1995 to 2007 in the Swedish Colorectal Cancer Registry was carried out. The final analysis included patients belonging to TNM stages I–III who had undergone R0 HP with a registered 5-year follow-up. Multivariate analysis was performed. Results: A total of 1188 patients were analysed (686 washout and 502 no washout). No differences were detected between the washout group and the no washout group concerning rates of LR [7% (49/686) vs. 10% (49/502); p = 0.13], distant metastasis (DM) [17% (119/686) vs. 18% (93/502); p = 0.65], and overall recurrence (OAR) [21% (145/686) vs. 24% (120/502); p = 0.29]. For both groups, the 5-year cancer-specific survival was below 50%. In multivariate analysis, washout neither decreased the risk of LR, DM, or OAR nor increased overall or the cancer-specific 5-year survival. Conclusions: The oncological outcome did not improve when washout was performed in HP for rectal cancer.</p>},
  author       = {Jörgren, F. and Johansson, R. and Arnadottir, H. and Lindmark, G.},
  issn         = {1123-6337},
  keyword      = {Hartmann’s procedure,Rectal cancer,Rectal washout,Recurrence,Survival},
  language     = {eng},
  month        = {05},
  number       = {5},
  pages        = {373--381},
  series       = {Techniques in Coloproctology},
  title        = {The importance of rectal washout for the oncological outcome after Hartmann’s procedure for rectal cancer : analysis of population-based data from the Swedish Colorectal Cancer Registry},
  url          = {http://dx.doi.org/10.1007/s10151-017-1637-5},
  volume       = {21},
  year         = {2017},
}