Z Lakkis1, D Vernerey2, D Mege3, J-L Faucheron4, Y Panis5, J-J Tuech6, J H Lefevre7, A Brouquet8, F Dumont9, C Borg10, A-S Woronoff11, A Meurisse2, B Heyd1, E Rullier12. 1. Department of Digestive Surgery, University Hospital of Besançon, Besançon, France. 2. Methodological and Quality of Life Unit in Oncology, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1098, University Hospital of Besançon, Besançon, France. 3. Department of Digestive and General Surgery, Timone Hospital, Marseille, France. 4. Colorectal Unit, Department of Surgery, Michallon University Hospital, Grenoble, France. 5. Department of Colorectal Surgery, Beaujon Hospital, Clichy, France. 6. Department of Digestive Surgery, Rouen University Hospital, Rouen, France. 7. Department of General and Digestive Surgery, Saint-Antoine Hospital, Sorbonne Université, Paris, France. 8. Department of Digestive and Oncological Surgery, Bicêtre Hospital, Paris, France. 9. General Surgical Oncology Department, Gustave Roussy, Villejuif, France. 10. Department of Medical Oncology, University Hospital of Besançon, Besançon, France. 11. Department of Doubs and Belfort Territory Cancer Registry, University Hospital of Besançon, Besançon, France. 12. Department of Colorectal Surgery, Haut-Lévèque Hospital, Pessac, France.
Abstract
BACKGROUND: Specific surgical and oncological outcomes in patients with rectal cancer surgery after a previous diagnosis of prostate cancer have not been well described. The aim of this study was to compare surgical outcomes in patients with rectal cancer with or without a history of prostate cancer. METHODS: Patients who had surgery for rectal cancer with (PC group) or without (no-PC group) previous curative treatment for prostate cancer were enrolled between January 2001 and December 2015. Comparisons between the two groups were performed by multivariable Cox analysis, and after propensity score matching in a 3 : 1 ratio for demographic and tumour characteristics, and surgical and oncological outcomes. RESULTS: A total of 944 patients with rectal cancer were enrolled, of whom 10·8 per cent had a history of prostate cancer. After matching, 83 patients who had received treatment for prostate cancer were compared with 249 who had not. The PC and no-PC groups were similar regarding patient characteristics. Extended total mesorectal excision, conversion to open surgery, transfusion and tumour perforation were more frequent in the PC group than in the no-PC group. Major surgical morbidity (28 versus 17·2 per cent; P = 0·036), anastomotic leakage (25 versus 13·7 per cent; P = 0·019) and permanent stoma (41 versus 12·4 per cent; P < 0·001) occurred more frequently in the PC group. Local recurrence was increased significantly in the PC group (17 versus 8·0 per cent; P = 0·019), and resulted in a significant decrease in disease-free and overall survival. CONCLUSION: Prostate cancer treatment increases short- and long-term surgical morbidity in patients with rectal cancer, and impairs oncological outcomes.
BACKGROUND: Specific surgical and oncological outcomes in patients with rectal cancer surgery after a previous diagnosis of prostate cancer have not been well described. The aim of this study was to compare surgical outcomes in patients with rectal cancer with or without a history of prostate cancer. METHODS:Patients who had surgery for rectal cancer with (PC group) or without (no-PC group) previous curative treatment for prostate cancer were enrolled between January 2001 and December 2015. Comparisons between the two groups were performed by multivariable Cox analysis, and after propensity score matching in a 3 : 1 ratio for demographic and tumour characteristics, and surgical and oncological outcomes. RESULTS: A total of 944 patients with rectal cancer were enrolled, of whom 10·8 per cent had a history of prostate cancer. After matching, 83 patients who had received treatment for prostate cancer were compared with 249 who had not. The PC and no-PC groups were similar regarding patient characteristics. Extended total mesorectal excision, conversion to open surgery, transfusion and tumour perforation were more frequent in the PC group than in the no-PC group. Major surgical morbidity (28 versus 17·2 per cent; P = 0·036), anastomotic leakage (25 versus 13·7 per cent; P = 0·019) and permanent stoma (41 versus 12·4 per cent; P < 0·001) occurred more frequently in the PC group. Local recurrence was increased significantly in the PC group (17 versus 8·0 per cent; P = 0·019), and resulted in a significant decrease in disease-free and overall survival. CONCLUSION:Prostate cancer treatment increases short- and long-term surgical morbidity in patients with rectal cancer, and impairs oncological outcomes.