Members Members Residents Job Board
Join Today Renew Your Membership Make A Donation
Preoperative Radiochemotherapy (RT-CHT) and Total Mesorectal Excision (TME) for Mid and Low Rectal Cancer

Abstracts
2002 Digestive Disease Week

# 103534 Abstract ID: 103534 Preoperative Radiochemotherapy (RT-CHT) and Total Mesorectal Excision (TME) for Mid and Low Rectal Cancer
Salvatore Pucciarelli, Paola Toppan, Marialuisa Friso, Carlo Aschele, Marzia Minante, Mario Lise, Padova, Italy

PURPOSE To analyze the outcome of a 12-yr consecutive series of pts with mid-low rectal cancer who underwent TME after neoadjuvant RT-CHT at a single institution. PATIENTS AND METHODS Among 522 pts operated on for rectal cancer between 1980 and 2001, 387 had mid-low rectal tumor. Since 1990, 111 (74 M, 37 F; mean age 58 yrs, range 26-79 yrs) have undergone TME after neoadjuvant RT-CHT (study group). Indications for neoadjuvant therapy were: stage II-III adenocarcinoma assessed by transrectal ultrasound and/or pelvic CT scan, ECOG performance score 0-2. Preoperative RT (45-50.4 Gys in 25-28 fractions) was administered in combination with 5-FU-based chemotherapy (bolus or continuous infusion). The following parameters were considered: acute toxicity, surgical procedure, radical surgery rate, pathologic stage (pTNM), postoperative mortality, local and distant recurrences, and overall survival. RESULTS. All pts concluded neoadjuvant treatment; 22 (20%) had grade 3+ acute toxicity. Surgical procedures were: abdominoperineal or Hartmann resection (n= 19), low anterior resection with stapled or hand-sewn anastomosis (n=88), and transanal local excision (n=4). Ninety-eight pts (82%) underwent radical surgery with one postoperative death. The median follow-up was 33 (range 0-121) months. The estimated 5-yrs OS and DFS rate were 70 and 75%, respectively. None of the pts had local, but 16 had distant recurrence. At the time of writing, 88 (80%) pts are alive and disease-free, 5 (4,5%) are alive with disease and 17 (16,3%) have died. CONCLUSIONS. Our findings suggest that in mid-low clinical stage II-III rectal cancer, neoadjuvant RT-CHT is feasible and the local control rate is high. The distant recurrences are still an unresolved question with this treatment.




Society for Surgery of the Alimentary Tract

Facebook Twitter YouTube

Email SSAT Email SSAT
500 Cummings Center, Suite 4400, Beverly, MA 01915 500 Cummings Center
Suite 4400
Beverly, MA 01915
+1 978-927-8330 +1 978-927-8330
+1 978-524-0498 +1 978-524-0498
Links
About
Membership
Publications
Newsletters
Annual Meeting
Join SSAT
Job Board
Make a Pledge
Event Calendar
Awards