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Purpose <p>To assess the relevance of peritoneal reflection involvement in long-term oncological outcomes in patients with rectal cancer.</p> Methods <p>Prospective observational study from a specialized colorectal unit that included a consecutive series of patients undergoing mesorectal excision for rectal cancer. Peritoneal reflection (PR) involvement was evaluated on pathological examination using Shepherd’s classification. Overall survival (OS), disease-free survival (DFS), and local recurrence (LR) were assessed.</p> Results <p>One hundred sixty patients were included in the present analysis. Peritoneal involvement was present in 28.2% of the 85 tumors above or at the level of PR. There were no differences in OS, DFS, or LR according to tumor’s height location. The 5-year OS, DFS, and LR for tumors involving PR were 58.3%, 61.7%, and 30.3%, respectively. Patients with peritoneal involvement had a higher LR rate (<i>p</i> = 0.02) and shorter OS (<i>p</i> = 0.04). Shepherd’s grade 4 peritoneal involvement was an independent risk factor for OS (HR 2.9; 95% CI 1.1–9.5, <i>p</i> = 0.04) and LR (HR 4.2; 95% CI 1.2–16.9, <i>p</i> = 0.04).</p> Conclusion <p>After rectal cancer resection, peritoneal involvement is an independent risk factor for local recurrence and poor survival.</p>

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Peritoneal reflection involvement as a prognostic factor in rectal cancer. Long-term oncological outcomes from a prospective study

  • 期刊论文

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  • 发表日期：

    2025年5月10日

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  • Eduardo Alvarez-Sarrado,
  • Matteo Frasson,
  • Jorge Sancho-Muriel,
  • Maria Jose Gomez-Jurado,
  • Hanna Cholewa,
  • Vicent Primo-Romaguera,
  • Monica Millan,
  • Adela Batista,
  • Polina Rudenko,
  • Blas Flor-Lorente,
  • Eduardo Garcia-Granero,
  • Francisco Giner

摘要

Purpose

To assess the relevance of peritoneal reflection involvement in long-term oncological outcomes in patients with rectal cancer.

Methods

Prospective observational study from a specialized colorectal unit that included a consecutive series of patients undergoing mesorectal excision for rectal cancer. Peritoneal reflection (PR) involvement was evaluated on pathological examination using Shepherd’s classification. Overall survival (OS), disease-free survival (DFS), and local recurrence (LR) were assessed.

Results

One hundred sixty patients were included in the present analysis. Peritoneal involvement was present in 28.2% of the 85 tumors above or at the level of PR. There were no differences in OS, DFS, or LR according to tumor’s height location. The 5-year OS, DFS, and LR for tumors involving PR were 58.3%, 61.7%, and 30.3%, respectively. Patients with peritoneal involvement had a higher LR rate (p = 0.02) and shorter OS (p = 0.04). Shepherd’s grade 4 peritoneal involvement was an independent risk factor for OS (HR 2.9; 95% CI 1.1–9.5, p = 0.04) and LR (HR 4.2; 95% CI 1.2–16.9, p = 0.04).

Conclusion

After rectal cancer resection, peritoneal involvement is an independent risk factor for local recurrence and poor survival.