Study: Poorer Prognosis for Rectal Cancer That Has Invaded Pelvic Wall

Rectal cancer that has invaded the pelvic wall indicates a poorer prognosis than previously reported and should be reclassified in the way a colorectal tumor is staged, according to researchers at the University of Minnesota Cancer Center.

"Standard staging of locally advanced (T4) rectal cancer should differentiate between tumors with and without pelvic side wall invasion," wrote the researchers in their study published in the journal Diseases of the Colon and Rectum.

Researchers performed a study of 84 patients with locally advanced rectal cancer over a 10-year period. The patients' cancers were staged for local invasion on the basis of final pathology (56 percent), on the basis of operative findings (23 percent), and on the basis of ultrasound images (21 percent).

The patients were classified as either having pelvic wall involvement or not. Feasibility for surgery, local control and overall survival were compared between the two groups.

Thirty-seven percent of the patients had involvement of the pelvic wall. Age and pelvic wall involvement were the only two factors independently linked with the probability of surgery, according to the researchers' analysis.

The only factor that affected the average survival in patients without distant metastasis was surgery. Researchers conclude that rectal cancers with pelvic and organ involvement have different rates of surgery feasibility and average survival, and suggest that these differences be reflected in the way a colorectal tumor is classified.

Other Sources: Diseases of the Colon and Rectum