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Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers
BACKGROUND: This study reviewed the impact of pre-operative chemoradiotherapy or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) for ultralow rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection...
Autores principales: | , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859360/ https://www.ncbi.nlm.nih.gov/pubmed/20346160 http://dx.doi.org/10.1186/1477-7819-8-23 |
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author | Lim, Yon Kuei Law, Wai Lun Liu, Rico Poon, Jensen TC Fan, Joe FM Lo, Oswens SH |
author_facet | Lim, Yon Kuei Law, Wai Lun Liu, Rico Poon, Jensen TC Fan, Joe FM Lo, Oswens SH |
author_sort | Lim, Yon Kuei |
collection | PubMed |
description | BACKGROUND: This study reviewed the impact of pre-operative chemoradiotherapy or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) for ultralow rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR). We examined surgical complications, local recurrence and survival. METHODS: Of the 1270 patients who underwent radical resection for rectal cancer from 1994 till 2007, 180 with tumors within 4 cm with either peranal coloanal anastomosis or APR were analyzed. Patients were compared in groups that had surgery only (Group A), pre-operative chemoradiotherapy (Group B), and post-operative therapy (Group C). RESULTS: There were 115 males and the mean age was 65.43 years (range 30-89). APR was performed in 134 patients while 46 had a sphincter-preserving resection with peranal coloanal anastomosis. The mean follow-up period was 52.98 months (range: 0.57 to 178.9). There were 69, 58 and 53 patients in Groups A, B, and C, respectively. Nine patients in Group B could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Group A vs. 29.3% in Group B vs. 39.6% in Group C, respectively. The local recurrence rate was significantly lower in Group B (8.6.9% vs. 21.7% in Group A vs. 33.9% in Group C) p < 0.05. The 5-year cancer-specific survival rates for Group A was 49.3%, Group B was 69.9% and Group C was 38.8% (p = 0.14). CONCLUSION: Pre-operative chemoradiation in low rectal cancer is not associated with a higher incidence of peri-operative complications and its benefits may include reduction local recurrence. |
format | Text |
id | pubmed-2859360 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-28593602010-04-27 Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers Lim, Yon Kuei Law, Wai Lun Liu, Rico Poon, Jensen TC Fan, Joe FM Lo, Oswens SH World J Surg Oncol Research BACKGROUND: This study reviewed the impact of pre-operative chemoradiotherapy or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) for ultralow rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR). We examined surgical complications, local recurrence and survival. METHODS: Of the 1270 patients who underwent radical resection for rectal cancer from 1994 till 2007, 180 with tumors within 4 cm with either peranal coloanal anastomosis or APR were analyzed. Patients were compared in groups that had surgery only (Group A), pre-operative chemoradiotherapy (Group B), and post-operative therapy (Group C). RESULTS: There were 115 males and the mean age was 65.43 years (range 30-89). APR was performed in 134 patients while 46 had a sphincter-preserving resection with peranal coloanal anastomosis. The mean follow-up period was 52.98 months (range: 0.57 to 178.9). There were 69, 58 and 53 patients in Groups A, B, and C, respectively. Nine patients in Group B could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Group A vs. 29.3% in Group B vs. 39.6% in Group C, respectively. The local recurrence rate was significantly lower in Group B (8.6.9% vs. 21.7% in Group A vs. 33.9% in Group C) p < 0.05. The 5-year cancer-specific survival rates for Group A was 49.3%, Group B was 69.9% and Group C was 38.8% (p = 0.14). CONCLUSION: Pre-operative chemoradiation in low rectal cancer is not associated with a higher incidence of peri-operative complications and its benefits may include reduction local recurrence. BioMed Central 2010-03-26 /pmc/articles/PMC2859360/ /pubmed/20346160 http://dx.doi.org/10.1186/1477-7819-8-23 Text en Copyright ©2010 Lim et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Lim, Yon Kuei Law, Wai Lun Liu, Rico Poon, Jensen TC Fan, Joe FM Lo, Oswens SH Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
title | Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
title_full | Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
title_fullStr | Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
title_full_unstemmed | Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
title_short | Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
title_sort | impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859360/ https://www.ncbi.nlm.nih.gov/pubmed/20346160 http://dx.doi.org/10.1186/1477-7819-8-23 |
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