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The impact of preoperative chemoradiotherapy on advanced low rectal cancer
Author(s) -
Kao PingSheng,
Chang ShihChing,
Wang LingWei,
Lee RheunChuan,
Liang WenYi,
Lin TzuChen,
Chen WeiShone,
Jiang JengKai,
Yang ShungHaur,
Wang HuannSheng,
Lin JenKou
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21711
Subject(s) - medicine , colorectal cancer , capecitabine , regimen , chemoradiotherapy , tegafur , preoperative care , surgery , radical surgery , stage (stratigraphy) , radiation therapy , anal cancer , t stage , overall survival , cancer , chemotherapy , paleontology , biology
Background Preoperative chemoradiotherapy (CCRT) followed by radical resection is an option for advanced low rectal cancer. This study was aimed to clarify the impact of CCRT on patients' outcome. Patients and Methods One hundred thirty‐six patients with rectal cancer (<10 cm from anal verge) were enrolled prospectively between July 2000 and December 2004. The preoperative clinical stage was T3, T4, or node‐positive disease. Sixty‐nine and 67 patients underwent surgery with and without preoperative CCRT, respectively. The regimen of pre‐op CCRT was a radiation dosage of 45 Gy in 20 fractions and oral tegafur‐uracil (UFUR) and leucovorin. Results There was no statistical difference in the preserved anorectal function between two groups after 5 years of follow‐up (62.3% vs. 47.8%; P = 0.125). The 5‐year overall survival and disease‐free survival (DFS) percentage were 88.4% and 76.8% for patients with preoperative CCRT, and 65.7% and 58.2% for patients without CCRT, respectively. Patients with preoperative CCRT had a higher overall survival rate and DFS ( P = 0.001 and 0.015). Conclusions In patients with advanced low rectal cancer, preoperative CCRT followed by radical surgery significantly improved overall survival and DFS compared with surgery alone. The effect of sphincter preservation with preoperative CCRT is questionable. J. Surg. Oncol. 2010;102:771–777. © 2010 Wiley‐Liss, Inc.