{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:57:13Z","timestamp":1777417033655,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The safety of inter\u2010sphincteric resection (ISR) for low rectal cancer with adverse histologic subtypes has been incompletely studied. The present study aims at determining the risk of local recurrence with this procedure in poorly differentiated and signet ring cell (PDSR) adenocarcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis from a single tertiary cancer centre of non\u2010metastatic primary rectal cancer &lt;6\u00a0cm from the anal verge that underwent ISR. Competing risk analysis and sub\u2010distribution hazard ratios for local recurrence free survivals were calculated to determine factors that influenced local recurrence with the competing risk of death from any cause to overcome the exceeding risk of distant metastasis associated with adverse histologic types.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred forty\u2010two patients underwent ISR and 22.6% has PDSR histology. At a median follow up of 61\u2009months, 15.6% of the PDSR cohort developed local recurrence (five patients) compared to 11.7% in the non\u2010PDSR group. PDSR histology influenced overall and disease free survival but not local recurrence on cox regression. On competing risk analysis, only ypT stage \u22653 predicted worse local recurrence free survival and not histology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The presence of PDSR histology did not increase the risk of local recurrence after ISR in this retrospective competing risk analysis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17155","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T02:07:41Z","timestamp":1629770861000},"page":"2475-2481","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Local recurrence with intersphincteric resection in adverse histology rectal cancers. 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