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Sphincter preservation in distal CT2N0 rectal cancer after preoperative chemoradiotherapy.

Wasserberg N, Kundel Y, Purim O, Keidar A, Kashtan H, Sadot E, Fenig E, Brenner B - Radiat Oncol (2014)

Bottom Line: Crude disease-free and overall survival were 82% and 86%, respectively.Factors associated with sphincter preservation were tumor location (OR=0.58, p=0.02, 95% CI=0.37-0.91) and pathological downstaging (OR=7.8, p=0.02, 95% CI=1.35-45.85).Chemoradiotherapy was well tolerated.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery B, Petach Tikva, 49100, Israel. nirw@clalit.org.il.

ABSTRACT

Background: Preoperative chemoradiotherapy is usually not indicated for cT2N0 rectal cancer. Abdominoperineal resection is the standard treatment for distal rectal tumors. The aim of the study was to evaluate the actual sphincter-preservation rate in patients with distal cT2N0 rectal cancer given neoadjuvant chemoradiotherapy.

Methods: Data were retrospectively collected for all patients who were diagnosed with distal cT2N0 rectal cancer at a tertiary medical center in 2000-2008 and received chemoradiotherapy followed by surgery (5-7 weeks later).

Results: Thirty-three patients (22 male) of median age 65 years (range, 32-88) were identified. Tumor distance from the anal verge ranged from 0 to 5 cm. R0 resection with sphincter preservation was accomplished in 22 patients (66%), with a 22% pathological complete response rate. Median follow-up time was 62 months (range 7-120). There were no local failures. Crude disease-free and overall survival were 82% and 86%, respectively. Factors associated with sphincter preservation were tumor location (OR=0.58, p=0.02, 95% CI=0.37-0.91) and pathological downstaging (OR=7.8, p=0.02, 95% CI=1.35-45.85). Chemoradiotherapy was well tolerated.

Conclusion: High rates of sphincter preservation can be achieved after preoperative chemoradiotherapy for distal cT2N0 rectal cancer, with tolerable toxicity, without compromising oncological outcome.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier estimated 5-year overall survival in 33 patients with cT2N0 rectal cancer treated with CRT followed by surgery.
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Fig1: Kaplan-Meier estimated 5-year overall survival in 33 patients with cT2N0 rectal cancer treated with CRT followed by surgery.

Mentions: The median duration of follow-up was 62 months (range, 7–112 months): 54 months for the LAR group (range, 7–112 months) and 89 months for the APR group (range, 23–110 months). There were no local failures in either group. Distant recurrence was documented in 3 patients in the APR group (27%) and 2 in the LAR group (9%). The estimated 5-year OS was 77% for the entire cohort (Figure 1), 80% for the APR group, and 75% for the LAR group (Figure 2). DFS for the whole cohort was 76%; the estimated rate was 70% for the APR group and 80% for the LAR group. There was no statistically significant between-group difference in either OS or DFS.Figure 1


Sphincter preservation in distal CT2N0 rectal cancer after preoperative chemoradiotherapy.

Wasserberg N, Kundel Y, Purim O, Keidar A, Kashtan H, Sadot E, Fenig E, Brenner B - Radiat Oncol (2014)

Kaplan-Meier estimated 5-year overall survival in 33 patients with cT2N0 rectal cancer treated with CRT followed by surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4215010&req=5

Fig1: Kaplan-Meier estimated 5-year overall survival in 33 patients with cT2N0 rectal cancer treated with CRT followed by surgery.
Mentions: The median duration of follow-up was 62 months (range, 7–112 months): 54 months for the LAR group (range, 7–112 months) and 89 months for the APR group (range, 23–110 months). There were no local failures in either group. Distant recurrence was documented in 3 patients in the APR group (27%) and 2 in the LAR group (9%). The estimated 5-year OS was 77% for the entire cohort (Figure 1), 80% for the APR group, and 75% for the LAR group (Figure 2). DFS for the whole cohort was 76%; the estimated rate was 70% for the APR group and 80% for the LAR group. There was no statistically significant between-group difference in either OS or DFS.Figure 1

Bottom Line: Crude disease-free and overall survival were 82% and 86%, respectively.Factors associated with sphincter preservation were tumor location (OR=0.58, p=0.02, 95% CI=0.37-0.91) and pathological downstaging (OR=7.8, p=0.02, 95% CI=1.35-45.85).Chemoradiotherapy was well tolerated.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery B, Petach Tikva, 49100, Israel. nirw@clalit.org.il.

ABSTRACT

Background: Preoperative chemoradiotherapy is usually not indicated for cT2N0 rectal cancer. Abdominoperineal resection is the standard treatment for distal rectal tumors. The aim of the study was to evaluate the actual sphincter-preservation rate in patients with distal cT2N0 rectal cancer given neoadjuvant chemoradiotherapy.

Methods: Data were retrospectively collected for all patients who were diagnosed with distal cT2N0 rectal cancer at a tertiary medical center in 2000-2008 and received chemoradiotherapy followed by surgery (5-7 weeks later).

Results: Thirty-three patients (22 male) of median age 65 years (range, 32-88) were identified. Tumor distance from the anal verge ranged from 0 to 5 cm. R0 resection with sphincter preservation was accomplished in 22 patients (66%), with a 22% pathological complete response rate. Median follow-up time was 62 months (range 7-120). There were no local failures. Crude disease-free and overall survival were 82% and 86%, respectively. Factors associated with sphincter preservation were tumor location (OR=0.58, p=0.02, 95% CI=0.37-0.91) and pathological downstaging (OR=7.8, p=0.02, 95% CI=1.35-45.85). Chemoradiotherapy was well tolerated.

Conclusion: High rates of sphincter preservation can be achieved after preoperative chemoradiotherapy for distal cT2N0 rectal cancer, with tolerable toxicity, without compromising oncological outcome.

No MeSH data available.


Related in: MedlinePlus