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In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Low anterior resection LAR and abdominoperineal resection APR are the two main surgical procedures after preoperative chemoradiotherapy CRT for locally advanced rectal cancer.
Based on higher response rate after intensified CRT, subgroup analyses were performed. The poorer prognosis of patients undergoing APR for locally advanced rectal cancer may be explained by clinicopathological characteristics. Abdominoperineal resection APR is a standard procedure 1 for low-third rectal cancer involving the sphincter and has been associated with a worse prognosis compared to LAR 2. As such, the Swedish Rectal Cancer Trial considered a resection margin of 5 cm below the tumour as essential and resulted in a higher rate of APR for tumours localized in the mid-rectum.
In the current practice, a distance of 2 cm or even less between the tumour and aboral resection margin is recommended. Here, we assessed the impact of surgical technique APR vs. LAR on clinical outcome and quality of life QoL. The study was approved by local ethics committee of the University of Erlangen, Germany. All methods were carried out in accordance with relevant guidelines and registrations. The trial design and clinical outcomes have been published previously 9 , Follow-up was conducted according to the guidelines of the German Cancer Society.
Furthermore, histopathological and clinical parameters were compared between groups. These data were processed in a manner comparable to the recent QoL analysis published by Kosmala et al. Statistical analysis was performed with the statistical computing software R version 4. Patient survival was calculated by KaplanβMeier analysis using the function survfit, with significance assessed by means of a Cox proportional hazards model using the function coxph and the log rank test.
