Preoperative chemoradiation for rectal cancer: results of multimodality management and analysis of prognostic factors
| Autor: | Amy L. Halverson, Steven J. Stryker, Anand T. Shivnani, Sherry Lim, Krystyna Kiel, William Small, Mark S. Talamonti |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer medicine.medical_treatment Preoperative care Gastroenterology Cohort Studies Internal medicine Preoperative Care medicine Humans Stage (cooking) Neoadjuvant therapy Survival analysis Aged Neoplasm Staging Retrospective Studies Aged 80 and over Rectal Neoplasms business.industry Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease Survival Analysis Neoadjuvant Therapy Surgery Treatment Outcome T-stage Female Neoplasm Recurrence Local business Chemoradiotherapy Follow-Up Studies |
| Zdroj: | The American Journal of Surgery. 193:389-394 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2006.09.030 |
| Popis: | Background Our goals were to examine the impact of neoadjuvant chemoradiation for rectal cancer on surgical outcomes and to determine prognostic factors predicting improved survival. Methods Retrospective cohort of 56 male and 44 female patients. Results After preoperative chemoradiation, 73% of patients had sphincter-preserving surgery. The 5-year disease-free (DFS) and overall survival rates were 77% and 81%, respectively. Twenty-five percent of patients showed a complete pathologic response. T-level downstaging and pathologic T stage did not correlate with recurrence or survival rates. Pathologic nodal stage was associated with a significant difference in recurrence rates (N 0 19%, N 1 20%, and N 2 75%, P = .038) and DFS (N 0 /N 1 vs. N 2 , 79% vs. 25%, P = .002). Conclusion Neoadjuvant chemoradiation resulted in a high rate of sphincter preservation. Complete pathologic responses after surgery were frequent and although pathologic T stage after surgery did not affect recurrence rates, pathologic nodal response was associated with improved recurrence and survival rates. |
| Databáze: | OpenAIRE |
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