Document Detail


Increased use of multidisciplinary treatment modalities adds little to the outcome of rectal cancer treated by optimal total mesorectal excision.
MedLine Citation:
PMID:  22395659     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Total mesorectal excision (TME) is the standard surgical treatment for rectal cancer. The roles of chemotherapy and radiotherapy have become more defined, accompanied by improvements in preoperative staging and histopathological assessment. We analyse our ongoing results in the light of changing patterns of treatment over consecutive time periods. METHODS: In total, 151 consecutive patients underwent potentially curative rectal excision for cancer in a single institution. Management and outcomes were compared between 1993-1999 and 2000-2007 which corresponded with the restructuring of the regional oncological services. RESULTS: We found an increase in patients treated with neoadjuvant chemoradiotherapy after 1999 (20/89 vs 1/62, p < 0.001). There was an increase in the mean number of lymph nodes examined (11.9 vs 9.4, p = 0.037). The locoregional recurrence rate was 5.3%. The rates were not significantly different between the two study periods [4/89 (4.5%) 1999-2007 vs 4/62 (6.5%) 1993-1999, p = 0.597]. There was no statistical difference in overall or disease-free survival in the time periods examined. CONCLUSIONS: Increasing use of neoadjuvant therapy and concomitant improvement in lymph node assessment did not translate into a concurrent reduction in the local recurrence, disease-free and overall survival rates. Our results demonstrate the enduring benefit of specialist training in TME in the outcome of rectal cancer surgery. This observational study suggests that low local recurrence rates are surrogate markers for improved overall and disease-free survival. Multidisciplinary team practice should be examined and made cost effective according to the individual unit's local recurrence rate in the light of this and other reports.
Authors:
Kah Hoong Chang; Myles J Smith; Oliver J McAnena; Arifin S Aprjanto; Joe F Dowdall
Related Documents :
23339449 - Risk factors of central nervous system relapse in mantle cell lymphoma.
18518789 - Clinical impact of trabectedin (ecteinascidin-743) in advanced/metastatic soft tissue s...
22865779 - Peripheral neurotoxicity of oxaliplatin in combination with 5-fluorouracil (folfox) or ...
22526039 - Preoperative cholangitis and metastatic lymph node have a negative impact on survival a...
22622599 - Medulloblastoma.
22830869 - Poster - thur eve - 53: analysis of the distribution of dose delivery during respirator...
24081649 - Comparison of dual-energy ct-derived iodine content and iodine overlay of normal, infla...
20967759 - Repeated radiofrequency ablation for management of patients with cirrhosis with small h...
21663859 - The role of nf-e2-related factor 2 in predicting chemoresistance and prognosis in advan...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-8
Journal Detail:
Title:  International journal of colorectal disease     Volume:  -     ISSN:  1432-1262     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607899     Medline TA:  Int J Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Surgery, Galway University Hospital, National University of Ireland, Galway, Republic of Ireland.
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:  Underutilisation of the gastroscope for total colonoscopy in adults: a survey of two European countr...
Next Document:  Molecular characterization of Acanthamoeba isolated in water treatment plants and comparison with cl...