eP237 - Is It Worth Performing Inter-Sphincteric Resection for Patients Having Rectal Adenocarcinoma with Oligo-Metastasis : A Study of 310 Patients

ePoster Presenter(s)

• SS

  Sanjay Singh, MS, MCh

  Clinical Fellow, Dept of Colorectal and Robotic Surgery
  Tata Memorial Centre, Homi Bhabha National Institute
  TATA MEMORIAL HOSPITAL
  Mumbai, Maharashtra, India

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Author(s)

• 

  Tejas P. Vispute, MS, MCh

  Clinical Fellow, Dept of Colorectal and Robotic Surgery
  Tata Memorial Center, Homi Bhabha National Institute, Mumbai
  Tata Memorial Center and Homi Bhabha National Institute, Mumbai
  Mumbai, Maharashtra, India

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• 

  YOGESH K. BANSOD, MS, MCH (SURGICAL ONCOLOGY) (he/him/his)

  CLINICAL FELLOW IN DIVISION OF COLORECTAL AND ROBOTIC SURGERY , TATA MEMORIAL HOSPITAL MUMBAI
  HOMI BHABHA NATIONAL INSTITUTE
  TATA MEMORIAL HOSPITAL , HOMI BHABHA NATIONAL INSTITUTE PAREL MUMBAI.
  MUMBAI, Maharashtra, India

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• AS

  Ankit Sharma, MS MCH SURGICAL ONCOLOGY

  CONSULTANT , DIVISION OF COLORECTAL AND ROBOTIC SURGERY TATA MEMORIAL HOSPITAL
  HOMI BHABHA NATIONAL INSTITUTE
  Tata Memorial Hospital, Mumbai
  MUMBAI, Maharashtra, India

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• MK

  Mufaddal K. Kazi, MS, MCh

  Associate Professor
  Tata Memorial Hospital
  Mumbai, Maharashtra, India

  Disclosure information not submitted.
• Ad

  Ashwin deSouza, MS, MCh, MRCSEd, DNB, FCPS, MNAMS

  Professor & Surgeon
  Tata Memorial Centre & Homi Bhabha National Institute, Mumbai, India
  Mumbai, Maharashtra, India

  Disclosure information not submitted.

Senior Author(s)

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  Avanish P. Saklani, MS, FRCS

  Professor and Chief of Colorectal Services
  Tata Memorial Hospital, Mumbai
  Tata Memorial hospital , Mumbai
  Mumbai, Maharashtra, India

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: As we have seen inter-sphincteric resection (ISR) being performed in metastatic rectal adenocarcinoma (with oligo-metastasis) patients, there has been a trend towards worse prognosis in this group. This study compares the outcomes of patients with and without pre-operative oligo-metastasis who underwent ISR, in terms of prognosisMethods/Interventions: Patients who underwent minimally invasive ISR over the period of ten years at a high volume tertiary cancer centre were selected for the study. Factors used for the assessment of prognosis were margin positivity (circumferential resection and distal margin), recurrence (both local and systemic) and stoma reversal rate. Descriptive analaysis was performedResults/Outcomes: Three hundred-ten patients underwent minimally invasive ISR of which 13 (4.2%) patients were having pre-operative oligo-metastasis and rest were non-metastatic. Higher recurrence (46%) and low stoma reversal rate (46%) was observed in the oligo-metastatic group with statistical significant difference. Though no local recurrence was seen in oligometastatic group the difference was not statistically different. Margin positivity was same in both the groups. Majority of the patients with oligo-metastasis received Neo-adjuvant chemotherapy.Conclusion/

Discussion: This study shows that the patients who undergo ISR with pre-operative oligo metastasis experience higher recurrence and low stoma reversal rate without affecting margin positivity. Since the number of patients with oligo-metastasis are very low in the present study, a larger sample size is required to further comment on this debate.FIGURE 1.Prognostic outcomes of patients with and without pre-operative oligo-metastasis who underwent inter-sphincteric resection.