Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2023; 15(6): 1104-1115
Published online Jun 27, 2023. doi: 10.4240/wjgs.v15.i6.1104
Long-term outcomes and failure patterns after laparoscopic intersphincteric resection in ultralow rectal cancers
Wen-Long Qiu, Xiao-Lin Wang, Jun-Guang Liu, Gang Hu, Shi-Wen Mei, Jian-Qiang Tang
Wen-Long Qiu, Gang Hu, Shi-Wen Mei, Jian-Qiang Tang, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Xiao-Lin Wang, Department of General Surgery, The Second Hospital of Yulin, Yulin 100021, Shaanxi Province, China
Jun-Guang Liu, Department of General Surgery, Peking University First Hospital, Beijing 100021, China
Author contributions: Qiu WL, Liu JG and Wang XL contributed equally to this work; Protocol/project development: Qiu WL, Tang JQ; Data collection or management: Qiu QL, Hu G, Mei SW, Liu JG, Wang XL. Data analysis: Qiu WL, Wang XL, Liu JG; Manuscript writing/editing: Qiu WL, Wang XL; All authors reviewed the manuscript.
Supported by The National Natural Science Foundation of China, No. 81272710; Beijing Nature Fund, No. 4232058; and Beijing Natural Fund Haidian Special, No. L222054
Institutional review board statement: The study was reviewed and approved by the National Cancer Center Institutional Review Board (Approval No. 17-116/1439).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Qiang Tang, MD, PhD, Chief Doctor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. doc_tjq@hotmail.com
Received: September 30, 2022
Peer-review started: September 30, 2022
First decision: January 3, 2023
Revised: January 29, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: June 27, 2023
Processing time: 258 Days and 11.3 Hours
Core Tip

Core Tip: We aimed to investigate the failure patterns and risk factors for local recurrence and distant metastasis in 368 patients who underwent iaparoscopic Intersphincteric resection (LsISR). Local recurrence and distant metastasis occurred in 13 (3.5%) and 42 (11.4%) patients, respectively. The 3-year overall survival, local recurrence-free survival, and distant metastasis-free survival rates were 91.3%, 97.1%, and 90.1%, respectively. Multivariate analyses revealed that LRFS was associated with positive lymph node status and poor differentiation, whereas the independent prognostic factors for DMFS were positive lymph node status and (y)pT3 stage. We believe that our study makes a significant contribution to the literature because it confirmed the oncological safety of LsISR for ultralow rectal cancer. This paper will be of interest to the readership of your journal because it demonstrated that poor differentiation, (y)pT3 stage, and lymph node metastasis are independent risk factors for treatment failure after LsISR, and thus patients with these factors should be carefully managed with optimal neoadjuvant therapy and surgical strategy.