UNASSIGNED: Background. Abdominoperineal resection (APR) has been associated with impaired survival in nonmetastatic @entity5 @entity1 . It is unclear whether this adverse outcome is due to the surgical procedure itself or is a consequence of @entity5 -related characteristics. Study Design. @entity1 were identified from the Surveillance, Epidemiology, and End Results database. The impact of APR compared to @entity254 ( @entity254 ) on survival was assessed by Cox regression and propensity-score matching. Results. In 36,488 @entity1 with @entity5 resection, the APR rate declined from 31.8% in 1998 to 19.2% in 2011, with a significant trend change in 2004 at 21.6% (P < 0.001). To minimize a potential time-trend bias, survival analysis was limited to @entity1 diagnosed after 2004. APR was associated with an increased risk of @entity5 -specific mortality after unadjusted analysis (HR = 1.61, 95% CI: 1.28-2.03, P < 0.01) and multivariable adjustment (HR = 1.39, 95% CI: 1.10-1.76, P < 0.01). After optimal adjustment of highly biased @entity1 characteristics by propensity-score matching, APR was not identified as a risk factor for @entity5 -specific mortality (HR = 0.85, 95% CI: 0.56-1.29, P = 0.456). Conclusions. The current propensity score-adjusted analysis provides evidence that worse oncological outcomes in @entity1 undergoing APR compared to @entity254 are caused by different @entity1 characteristics and not by the surgical procedure itself.

Survival after Abdominoperineal and Sphincter-Preserving Resection in Nonmetastatic XXXX : A Population-Based Time-Trend and Propensity Score-Matched SEER Analysis.

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'cancer', 'rectal cancer'] @entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity254 :: ('MESH:C563598', 'Disease') :: ['CAA', 'coloanal anastomosis']
@entity5 :: (MESH:D009369,Disease) :: ['Rectal Cancer']
