Results of rectal resection in metastatic cancer

AIM: to evaluate results of rectal resection in metastatic rectal cancer.

PATIENTS AND METHODS: a retrospective analysis of the results of treatment of 84 patients with symptomatic rectal cancer at stage IV, who underwent rectal resection in 2015-2020.

RESULTS: anastomotic leak developed in 5 (5.9%) patients. Postoperative mortality rate was 1 (1.2%). Ileostomy closure was performed in 66 patients (78.6%) 17.9 months after initial surgery. Progression of the disease was detected in 60 (71.4%) patients at following organs: liver (42.9%), peritoneum (19%), lungs (15.5%). Stabilization was significantly higher after systemic chemotherapy before and after perioperative chemotherapy comparing to patients who had preoperative radiation (p = 0.013). Proportional Cox regression model risks showed that the chances of death in patients with advanced rectal cancer after surgery was 4.1 times higher for peritoneal carcinomatosis, 2.9 times for liver metastases and 1.5 for multi organ metastasis.

CONCLUSION: low anterior resection with defunctioning ileostomy is associated with acceptable anastomotic leak rate (5.9%) and mortality (1.2%). Systemic chemotherapy in combination with target agents is preferable initial treatment in patients with metastatic rectal cancer.

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