Document Detail


Improved outcomes for rectal cancer in the era of preoperative chemoradiation and tailored mesorectal excision: a series of 338 consecutive cases.
MedLine Citation:
PMID:  23336654     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Neoadjuvant chemoradiation (CRT), tailored mesorectal excision, and intraoperative radiotherapy (IORT) have become the leading measures for rectal cancer treatment. The objective of this study was to evaluate early and long-term results of a multimodal treatment model for rectal cancer followed by curative surgery. Prospectively collected hospital records of 338 patients surgically treated for rectal cancer between January 1998 and December 2008 were retrospectively reviewed. Patients with high rectum level cancers and those with middle and low rectum cancers with clinical stage T1 to T2 underwent surgery, whereas those with T3 to T4 and N+ disease at the middle and low rectum received neoadjuvant CRT in 96.2 per cent of cases. Short-course neoadjuvant radiotherapy was not considered for neoadjuvant treatment. Postoperative major complications and mortality rates were 12.7 and 2.3 per cent, respectively. Overall 5-year disease-specific and disease-free survival were 80 and 73.1 per cent, respectively, whereas local recurrence rate was 6.1 per cent. At multivariate analysis, nodal status and circumferential margin status were independently associated with poor survival; local recurrence rates were independently affected by nodal and marginal status and tumor stage. The extent of mesorectal excision should be tailored depending on tumor location and the use of neoadjuvant chemotherapy, combined with IORT in advanced middle and low rectal cancer, leading to remarkable tumor downstaging with excellent prognosis in responding patients.
Authors:
Fabio Pacelli; Alejandro M Sanchez; Marcello Covino; Antonio P Tortorelli; Maurizio Bossola; Vincenzo Valentini; Maria A Gambacorta; Giovanni B Doglietto
Related Documents :
8156264 - Advances in behavioral intervention in comprehensive cancer treatment.
20034784 - Estimation of an optimal chemotherapy utilisation rate for breast cancer: setting an ev...
19132464 - Chemotherapy for small-bowel adenocarcinoma at a single institution.
16431034 - Crohn's disease leading to bowel cancer may be avoided by consumption of soya isoflavon...
7641154 - Can the clinical course of cancer be influenced by non-antineoplastic drugs?
15549424 - Comparison of proposed diagnostic criteria with fact-f and vas for cancer-related fatig...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  79     ISSN:  1555-9823     ISO Abbreviation:  Am Surg     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-61     Citation Subset:  IM    
Affiliation:
Departments of Surgical Sciences, Catholic University, School of Medicine, Rome, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Increasing numbers of rib fractures do not worsen outcome: an analysis of the national trauma data b...
Next Document:  Impact of surgical mentorship on retroperitoneoscopic adrenalectomy with comparison to transperitone...