Preoperative Indicators of Poor Outcome in Locally Advanced Rectal Cancer at a County Hospital

Aaron B Parrish, Brian W Mac Laughlin, Nicholas C Figueroa, Gregory R Bryant, Amy H Kaji, Patrick C Choi and Ravin R Kumar

Department of Surgery, Harbor-UCLA Medical Center, USA
Department of Radiology, Harbor-UCLA Medical Center, USA
Department of Emergency Medicine, Harbor-UCLA Medical Center, USA

^*Correspondance to: Ravin R Kumar 

 PDF  Full Text DOI: 10.25107/2474-1647.1262

Abstract

Background: Locally advanced rectal cancer (LARC) is associated with high rates of both local and metastatic recurrence. Preoperative predictors can help determine which patients are at risk for recurrence.Methods: A retrospective analysis of LARC patients at a county institution. Patients were grouped into that disease free at 2 years vs. those with unrepeatability or recurrence. Variables analyzed were available preoperatively and included demographics, tumor characteristics, and laboratory values.Results: Out of96 patients, 55 had a successful outcome (SO) and 31 had an unsuccessful outcome (UO). On univariate analysis, significant predictors of UO were larger tumor size (p=0.002), extension into levator ani muscles (p=0.001), lower albumin (p=0.006), lower hemoglobin (p=0.02), and lower MCV (p=0.04). The only significant variable on multivariate analysis was extension into levators (OR 5.6, CI 1.5-21.1).Conclusion: LARC patients found to have these high risk characteristics are more likely to have an unresectable cancer or recurrence. These patients should be considered for additional imaging after neoadjuvant chemoradiation, as it may lead to a change in the operative plan.

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Cite the article

Parrish AB, Mac Laughlin BW, Figueroa NC, Bryant GR, Kaji AH, Choi PC, et al. Preoperative Indicators of Poor Outcome in Locally Advanced Rectal Cancer at a County Hospital. Clin Surg. 2016; 1: 1263.