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Impact pronostique et thérapeutique du cancer de prostate sur la prise en charge du cancer du rectum

Abstract : Rectum and prostate are two pelvic organs with intimate anatomical relationships. Previous or synchronous prostate cancer may alter outcomes and management of rectal cancer.Using datas from three multicenter retrospective cohorts, three objectives have been explored. First, assessing the impact of a history of prostate cancer on morbidity and prognosis of resected rectal cancer. Then, assessing safety and morbidity of a strategy with bowel restorative surgery. Finally, describing management and treatment of synchronous rectal and prostate cancer.A history of prostate cancer significantly increased the rate of anastomotic leakage at rectal surgery (25% vs. 14%, p = 0.019) and local recurrence rate (17% vs. 8%, p = 0.019). Then, we did not find any significant increased morbidity when digestive anastomosis was performed (p = 0.08). Delayed coloanal anastomosis might be a safe option. Finally, simultaneous curative management is possible for synchronous prostate and rectal cancers; an algorithm could help decision-making.Management of metachronous or synchronous rectal and prostate cancers is uncommon. Multidisciplinary and specialized decision is paramount.
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Submitted on : Tuesday, April 20, 2021 - 4:06:23 PM
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Zaher Lakkis. Impact pronostique et thérapeutique du cancer de prostate sur la prise en charge du cancer du rectum. Médecine humaine et pathologie. Université Bourgogne Franche-Comté, 2019. Français. ⟨NNT : 2019UBFCE012⟩. ⟨tel-03203185⟩

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