TY - JOUR
T1 - Preoperative chemoradiation for rectal cancer
T2 - results of multimodality management and analysis of prognostic factors
AU - Shivnani, Anand T.
AU - Small, William
AU - Stryker, Steven J.
AU - Kiel, Krystyna D.
AU - Lim, Sherry
AU - Halverson, Amy L.
AU - Talamonti, Mark S.
PY - 2007/3/1
Y1 - 2007/3/1
N2 - 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 (N0 19%, N1 20%, and N2 75%, P = .038) and DFS (N0/N1 vs. N2, 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.
AB - 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 (N0 19%, N1 20%, and N2 75%, P = .038) and DFS (N0/N1 vs. N2, 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.
KW - Neoadjuvant chemoradiation
KW - Rectal cancer
KW - Rectal surgery
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U2 - 10.1016/j.amjsurg.2006.09.030
DO - 10.1016/j.amjsurg.2006.09.030
M3 - Article
C2 - 17320541
AN - SCOPUS:33847200792
SN - 0002-9610
VL - 193
SP - 389
EP - 394
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -