2005 Abstracts: Mucinous Type Distal Rectal Adenocarcinoma:Results Following Preoperative Chemoradiation Therapy
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Mucinous Type Distal Rectal Adenocarcinoma:Results Following Preoperative Chemoradiation Therapy
Rachel B. Rossine, Rodrigo O. Perez, University of Sao Paulo Surgery of the Alimentary Tract Division, Sao Paulo, SP, Brazil; Angelita Habr-Gama, University of Sao Paulo Surgery of the Alimentary Tract Division, SP, sp, Brazil; Viviane Rawet, Afonso H. Sousa, Sidney Arazawa, Desiderio Kiss, Joaquim G. Rodrigues, University of Sao Paulo Surgery of the Alimentary Tract Division, Sao Paulo, SP, Brazil; Roger Coser, University of Sao Paulo Colorectal Surgery Division, sao Paulo, SP, Brazil
Objective:Mucinous type colorectal adenocarcinoma may be associated with distinctive clinico-pathologicaland genetic features. Preoperative chemoradiation therapy (CRT) has been proposed as the preferred treatment strategy for distal rectal cancer leading to significant tumor downstaging e better local disease control. However, some patients may actually experience early disease recurrence and poor prognosis. Possibly, mucinous tumors of the distal rectum could be responsive to CRT leading to improved survival and decreased recurrence.
Patients and Methods:Patients with non-metastatic distal rectal adenocarcinoma, managed by preoperative CRT followed by radical surgery were retrospectively reviewed. These patients were compared to patients with mucinous type colon and upper rectal cancer treated by radical surgery alone. Patients were compared in terms of clinical and pathological features, recurrence and survival. Recurrence was further subdivided into local or systemic recurrence. Results:13 patients with mucinous type distal rectal adenocarcinoma and 14 patients with mucinous type colorectal cancer were eligible for the study. There were no significant differences between pT, pN, final tumor size or final UICC stage between both groups. 12 patients with distal rectal cancer required APR. Overall, there were 5 recurrences (38%) in patients with distal rectal cancer and 2 recurrences (14%) in patients with colorectal cancer (p=0.2). There were no statistical differences in terms of overall and disease-free survival. Conclusions:Mucinous type distal rectal cancer following preoperative CRT and radical surgery is associated with high recurrence rates. Mucinous type distal rectal adenocarcinoma was not associated with improved outcome or significant downstaging when managed by preoperative CRT. Possibly, there may be no benefit in terms of tumor downstaging and disease-free survival with neoadjuvant approach for mucinous type distal rectal cancer.
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