Nerve-sparing Surgery for Advanced Rectal Cancer Patients: Special Reference to Dukes C Patients |
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Authors: | Norio Saito Keiji Koda Nobuhiro Takiguchi Kenji Oda Hiroaki Soda Masao Nunomura Hiromi Sarashina Nobuyuki Nakajima |
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Institution: | (1) Department of Surgery 1, Chiba University School of Medicine, 1-8-1 Inohana Chuo-ku, Chiba 260-0856, Japan, JP |
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Abstract: | Several nerve-sparing operations for advanced rectal cancer that aim to preserve genitourinary function without compromising
tumor clearance have been developed in Japan. The aim of this study was to evaluate the survival and local recurrence of these
procedures in Dukes B and C patients. A total of 177 patients with advanced rectal cancer underwent curative nerve-sparing
surgery (NSS) over the last 11 years; 52 were Dukes B patients and 54 were Dukes C. Altogether 36 had Dukes C1 and 18 had
Dukes C2 tumors, 13 with lateral lymph node metastases, designated lateral LN(+). The 5-year survival rate was 92% for Dukes
B, 67% for Dukes C1, and 39% for Dukes C2 patients: 11% for Dukes C2 patients with lateral LN(+). The local recurrence rate
was 6% for Dukes B, 11% for Dukes C1, and 33% for Dukes C2 patients: 20% for the lateral LN(−) group and 39% for the lateral
LN(+) group. Almost all of the patients undergoing NSS could micturate spontaneously, but preservation of sexual function
was not as successful. Although there is no guarantee of preserving satisfactory sexual function, our NSS is an acceptable
procedure for Dukes B, C1, and C2 patients without lateral lymph node metastases. |
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