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International Journal of Colorectal Disease

, Volume 34, Issue 1, pp 97–104 | Cite as

Survival and peri-operative outcomes among patients with rectal cancer: the role of prior radiotherapy due to prostate cancer

  • Adina E. FeinbergEmail author
  • Christopher J. D. Wallis
  • Robert K. Nam
  • Usmaan Hameed
Original Article
  • 119 Downloads

Abstract

Purpose

Patients with rectal cancer (RCa) and prior radiation for prostate cancer (PCa) are clinically complicated and may have worse outcomes than other RCa patients. This study investigates the impact of previous radiation for PCa on survival for patients with RCa.

Method

We conducted a population-based study identifying men who underwent surgical treatment of RCa from 2002 to 2010. Patients were classified into three cohorts: no prior PCa, prior PCa treated without radiotherapy, and prior PCa treated with radiotherapy. The primary outcome was overall survival. Secondary outcomes included RCa surgical approach, ICU admission, length of stay, ER visits, and delayed formation of a new stoma.

Results

Seven thousand ninety-six men underwent surgery for RCa; 6867 patients had no prior PCa, 58 had prior PCa treated without radiotherapy, and 171 had prior PCa treated with radiotherapy. The 5-year overall survival was 62% (95% CI 61–64%) for patients without prior PCa, 46% (95% CI 25–65%) for patients with prior PCa treated without radiotherapy, and 42% (95% CI 29–54%) for patients with prior PCa treated with radiotherapy (p < 0.0001). In multivariable analysis, patients with prior PCa treated with radiotherapy were at increased risk of death (aHR 1.38, 95% CI 1.12–1.69) compared to those without prior PCa. Furthermore, patients with prior PCa treated with radiotherapy had a significantly increased risk of resection with permanent stoma.

Conclusions

Prior radiotherapy for PCa is a poor prognostic factor in RCa patients with significantly increased risk of death. Additionally, patients with prior radiotherapy for PCa are more likely to require a permanent stoma.

Keywords

Colorectal neoplasia Radiation Survival Outcomes Colorectal surgery Prostate cancer Radiotherapy for prostate cancer 

Notes

Author’s contribution

Wallis participated in the analysis and interpretation of the data, drafting and revising the article, final approval for the version to be published and accountable for all aspects of the work.

Feinberg participated in the conception of the work, interpretation of the data, drafting and revising the article, final approval for the version to be published and accountable for all aspects of the work.

Nam participated in the interpretation of the data, revising the article, final approval for the version to be published and accountable for all aspects of the work.

Hameed participated in the conception of the work, interpretation of the data, revising the article, final approval for the version to be published and accountable for all aspects of the work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

384_2018_3175_MOESM1_ESM.pdf (61 kb)
ESM 1 (PDF 60 KB)
384_2018_3175_MOESM2_ESM.docx (96 kb)
ESM 2 (DOCX 96 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of General SurgeryUniversity of TorontoTorontoCanada
  2. 2.Division of Urology, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada
  3. 3.Institute for Health Policy, Management & EvaluationUniversity of TorontoTorontoCanada
  4. 4.Division of General SurgeryNorth York General HospitalTorontoCanada

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