The impact of preoperative chemoradiotherapy on advanced low rectal cancer
Ping-Sheng Kao MD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorShih-Ching Chang MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorLing-Wei Wang MD
Cancer Center, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorRheun-Chuan Lee MD
Department of Radiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorWen-Yi Liang MD
Department of Pathology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTzu-Chen Lin MD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorWei-Shone Chen MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorJeng-Kai Jiang MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorShung-Haur Yang MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorHuann-Sheng Wang MD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Jen-Kou Lin MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, No 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. Fax: +886-2-28757639Search for more papers by this authorPing-Sheng Kao MD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorShih-Ching Chang MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorLing-Wei Wang MD
Cancer Center, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorRheun-Chuan Lee MD
Department of Radiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorWen-Yi Liang MD
Department of Pathology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorTzu-Chen Lin MD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorWei-Shone Chen MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorJeng-Kai Jiang MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorShung-Haur Yang MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorHuann-Sheng Wang MD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Jen-Kou Lin MD, PhD
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, No 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. Fax: +886-2-28757639Search for more papers by this authorAbstract
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.
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