| Long-term results after neoadjuvant radiochemotherapy for locally advanced resectable extraperitoneal rectal cancer. | |
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MedLine Citation:
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PMID: 16456636 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: This study was designed to evaluate long-term outcome in locally advanced resectable extraperitoneal rectal cancer treated by preoperative radiochemotherapy. METHODS: Eighty-three consecutive patients who developed locally advanced resectable extraperitoneal rectal cancer underwent preoperative concomitant radiochemotherapy followed by surgery, including total mesorectal excision. RESULTS: Median follow-up was 108 (range, 10-169) months. The living patients underwent complete follow-up of, at least, nine years. Fourteen patients developed local recurrence. The time to detection was longer than two years in eight cases and longer than five years in four. Twenty-one patients developed metastases, 19 within the first five years from surgery. At the univariate analysis, clinical stage at presentation, lymph node involvement at clinical restaging after neoadjuvant therapy, and pT and pN stage were found positively correlated to the incidence of metastases. At the multivariate analysis, the only factors which confirmed a positive correlation were pT stage and pN stage. The actuarial overall survival at five, seven, and ten years was 75.5, 67.8, and 60.4 percent, respectively. The same figures for cancer-related survival were 77.9, 70, and 65.8 percent. At the univariate analysis, factors directly correlated with worse survival were: TNM stage at clinical restaging after neoadjuvant therapy (in particular lymph node involvement) pTNM, pT, and pN. At the multivariate analysis the only factors that confirmed a correlation with worse survival were pTNM, pT, and pN. CONCLUSIONS: Long- term follow-up allows to individuate 28 percent of all local relapses after the first five years from surgery. Postoperative stage is highly predictive of prognosis. |
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Authors:
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Claudio Coco; Vincenzo Valentini; Alberto Manno; Claudio Mattana; Alessandro Verbo; Numa Cellini; Maria Antonietta Gambacorta; Marcello Covino; Giovanna Mantini; Francesco Miccichè; Giorgio Pedretti; Luigi Petito; Gianluca Rizzo; Maurizio Cosimelli; Fabrizio Ambesi Impiombato; Aurelio Picciocchi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 49 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-03-13 Completed Date: 2006-04-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 311-8 Citation Subset: IM |
Affiliation:
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Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols / therapeutic use Female Fluorouracil / administration & dosage Follow-Up Studies Humans Italy / epidemiology Lymph Nodes / pathology Male Middle Aged Mitomycin / administration & dosage Multivariate Analysis Neoadjuvant Therapy* Neoplasm Recurrence, Local Prognosis Rectal Neoplasms / mortality*, pathology, therapy* Survival Rate |
| Chemical | |
Reg. No./Substance:
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50-07-7/Mitomycin; 51-21-8/Fluorouracil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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