Sex differences between cT4b and pT4b rectal cancers

Abstract

We retrospectively evaluated rectal cancer surgery cases in which resection had been performed for invasion of other organs in terms of pathologic findings from the viewpoint of sex differences. We enrolled 61 consecutive patients with rectal cancer who had undergone curative surgery with resection of invaded adjacent organs. We investigated invasion of adjacent organs in terms of pathologic findings according to sex differences. Among males, 4 cases (13.8%) had received combined radical resections of more than 2 organs, while the number of such female cases was 15 (46.9%). The difference between males and females was statistically significant (P = 0.006). Among male cases, histopathologic invasion was present in 4 (13.8%), while 9 female cases (28.1%) showed this feature. Nevertheless, there was not a statistically significant difference between males and females (P = 0.08); the rate in females was roughly twice that in males. No significant difference was recognized in the overall survival rates between males and females, but more females than males experienced local recurrence. In cases with rectal cancer invading neighboring organs, the effect of the invasion must be carefully determined, and the most appropriate operative approach selected accordingly.

Fig. 1

This figure shows the partially resected posterior wall of the vagina. The cancer shows discontinuous spread (black arrow), and the shortest distance between the deepest part of the cancer and the incised surface (dotted line) was only 500 μm (dotted black arrow). H&E (×100).

Fig. 2

This figure shows the overall survival rates of the study patients. Male: pT4a vs. Female pT4a : p=0.561; Male: pT4b vs. Female pT4b : p=0.728; Male: pT4a vs. Male pT4b : p=0.005; Female: pT4a vs. Female pT4b : p<0.561.