Preoperative Radiochemotherapy in T3 Operable Low Rectal Cancers: A Gold Standard?

Fucini, Claudio; Pucciani, Filippo; Elbetti, Claudio; Gattai, Riccardo; Russo, Antonio
July 2010
World Journal of Surgery;Jul2010, Vol. 34 Issue 7, p1609
Academic Journal
Preoperative chemoradiation followed by total mesorectal excision (TME) has become a standard treatment of preoperatively staged T3 low rectal cancers in many institutions; however, a direct comparison of generalized preoperative versus selective adjuvant chemoradiation has never been assessed in a clinical practice setting. Over a 4-year period, 80 patients with T3 primary low adenocarcinoma of the rectum, judged operable at preoperative staging, were offered preoperative chemoradiation. Forty-seven patients (Group I) accepted the neoadjuvant treatment and 33 (Group II) preferred immediate surgery and postoperative chemoradiation if indicated. Major postoperative complications occurred in 21% of Group I versus in 11% of Group II ( p = 0.3) patients. After a mean follow-up of 92 months, the local recurrence rate was 4 and 9% ( p = 0.4), metastasis rate was 30 and 24% ( p = 0.5), 5-year survival probability was 0.79 (95% CI = 0.49–0.92) and 0.82 (95% CI = 0.70–1.00) (log-rank test, p = 0.6) for Group I and Group II, respectively. In T3 operable low rectal cancers, selective postoperative radiochemotherapy yielded similar long-term results regarding recurrence rate and survival as extended preoperative chemoradiation.


Related Articles

  • Outcome of patients with clinical stage II or III rectal cancer treated without adjuvant radiotherapy. Fujita, Shin; Yamamoto, Seiichiro; Akasu, Takayuki; Moriya, Yoshihiro // International Journal of Colorectal Disease;Nov2008, Vol. 23 Issue 11, p1073 

    To clarify the indications for preoperative adjuvant radiotherapy for rectal cancer, the outcome of patients who underwent curative surgery without adjuvant radiotherapy was investigated. A total of 817 consecutive patients who underwent curative surgery for clinical stage II or III rectal...

  • Trial Watch: Immunostimulatory cytokines. Vacchelli, Erika; Eggermont, Alexander; Fridman, Wolf Hervé; Galon, Jérôme; Zitvogel, Laurence; Kroemer, Guido; Galluzzi, Lorenzo // OncoImmunology;Jul2013, Vol. 2 Issue 7, pe24850-1 

    During the past two decades, the notion that cancer would merely constitute a cell-intrinsic disease has gradually been complemented by a model postulating that the immune system plays a relevant role during all stages of oncogenesis and tumor progression. Along with this conceptual shift,...

  • Comparing treatment outcomes of different chemotherapy sequences during intensity modulated radiotherapy for advanced N-stage nasopharyngeal carcinoma patients. Xueming Sun; Lei Zeng; Chunyan Chen; Ying Huang; Fei Han; Weiwei Xiao; Shuai Liu; Taixiang Lu // Radiation Oncology;2013, Vol. 8 Issue 1, p1 

    Background N-stage is related to distant metastasis of nasopharyngeal carcinoma (NPC) patients. We performed this study to compare the efficacy of different chemotherapy sequences in advanced N-stage (N2 and N3) NPC patients treated with intensity modulated radiotherapy (IMRT). Methods From 2001...

  • Thymic large cell neuroendocrine carcinoma: report of a resected case - a case report. Ogawa, Fumihiro; Iyoda, Akira; Amano, Hideki; Nezu, Kenji; Shi-Xu Jiang; Okayasu, Isao; Satoh, Yukitoshi // Journal of Cardiothoracic Surgery;2010, Vol. 5, p115 

    Thymic large cell neuroendocrine carcinomas (LCNECs) are very rare. We here describe a case in which the tumor could be completely resected. A 55-year-old male was admitted to our hospital for treatment of an anterior mediastinal tumor found at a regular health check-up. The patient underwent an...

  • Tumour size and vascular invasion predict distant metastasis in stage I breast cancer. Grade distinguishes early and late metastasis. Westenend, P. J.; Meurs, C. J. C.; Damhuis, R. A. M. // Journal of Clinical Pathology;Feb2005, Vol. 58 Issue 2, p196 

    Background: Recent Dutch guidelines recommend adjuvant systemic treatment (AST) for women with high grade stage 1 breast carcinoma ⩾ 1 cm. High grade is defined as Bloom and Richardson grade 3 (B&R3), Nottingham modification, or mitotic activity (MAI) ⩾ 10/1.59 mm². Aims: To...

  • Long-Term Outcome of Differentiated Thyroid Carcinoma: Experience in a Developing Country. Bhargav, Panchagan Rama Kant; Mishra, Anjali; Agarwal, Gaurav; Agarwal, Amit; Pradhan, Prasanta Kumar; Gambhir, Sanjay; Verma, Ashok Kumar; Mishra, Saroj Kanta // World Journal of Surgery;Jan2010, Vol. 34 Issue 1, p40 

    The presentation and outcome of differentiated thyroid carcinoma (DTC) in developing countries are different from the developed nations. We report the clinicopathologic profile and long-term outcome of DTC in an iodine-deficient area (IDA) in a developing country. This retrospective study...

  • A case with synchronous multiple liver metastases from gastric carcinoma: postoperative long-term disease-free survival. Munekage, Masaya; Okabayashi, Takehiro; Hokimoto, Norihiro; Sugimoto, Takeki; Maeda, Hiromichi; Namikawa, Tsutomu; Dabanaka, Ken; Kobayashi, Michiya; Araki, Keijiro; Hanazaki, Kazuhiro // Langenbeck's Archives of Surgery;Sep2009, Vol. 394 Issue 4, p749 

    We herein report a case with synchronous multiple liver metastases from gastric carcinoma surviving disease-free for more than 10 years after hepatic resection. A 64-year-old male admitted to our hospital because of constitutional wariness. Preoperative diagnosis was type 1 gastric cancer at the...

  • Vertical versus Transverse Incision in Low Anterior Resection for Rectal Cancer. Zheng Liu; Guiyu Wang; Yinggang Chen; Yihui Wang; Qiang Li; Rui Huang; Xishan Wang // American Surgeon;Feb2013, Vol. 79 Issue 2, p215 

    The article discusses a case study which compared vertical and transverse incision for laparotomy of the lower abdomen. The study involved patients with rectal cancer who underwent low anterior resection (LAR) through a vertical or transverse incision at a hospital from March 1, 2009 to August...

  • Hand-Sewn Coloanal Anastomosis for Distal Rectal Cancer: Long-Term Clinical Outcomes Baik, Seung Hyuk; Kim, Nam Kyu; Lee, Kang Young; Sohn, Seung Kook; Cho, Chang Hwan // Journal of Gastrointestinal Surgery;Jul2005, Vol. 9 Issue 6, p775 

    As the oncologic safety of coloanal anastomosis (CAA) has been proved by many other authors, the incidence of CAA following ultralow anterior resection has increased. The purpose of this study is to evaluate the functional outcome and complications of patients who underwent ultralow anterior...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics