Document Detail


Long-term results after neoadjuvant radiochemotherapy for locally advanced resectable extraperitoneal rectal cancer.
MedLine Citation:
PMID:  16456636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  49     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-13     Completed Date:  2006-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  311-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
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:
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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