Objective: Rectosigmoid junction is hard to define clinically. Its clinicopathological features seem different when compared to the ones of the sigmoid and upper rectal cancer. This study investigated the outcome and survival in patients with postoperative stage II/III sigmoid, rectosigmoid and upper third rectal cancer treated with upfront surgery.
Methods: Patients with sigmoid, rectosigmoid junction and upper rectal cancer underwent upfront curative surgery in the period (2016-2022) in tertiary institutions are retrospectively examined. Patient, tumor and follow-up data divided into three groups were retrospectively reviewed and compared for outcome and overall survival.
Results: Of a total number of 76 patients, 32 had rectosigmoid junction cancer, followed by sigmoid and upper third rectal cancer (in 27 and 17 patients, respectively). Most of the patients (63) presented with postoperative stage III. The mean follow-up period was 34.22 months. Patients with positive lymph nodes had worse survival (p=0.016). Perineural invasion affected the survival significantly (p=0.022). Rectosigmoid junction cancer showed the worst survival in comparison with sigmoid and upper rectal cancer (p=0.041).
Conclusion: Rectosigmoid junction cancer had the worst overall survival between the investigated groups. Perineural invasion presented as an independent factor for survival. The clinical behavior of the rectosigmoid junction cancer differs from the other cancers of the “terminal colon”.