Local recurrence after surgery of locally advanced rectal cancer treated with or without preoperative chemoradiotherapy

Q4 Medicine
M. Djurić, D. Lukić, Z. Radovanovic, Aleksandar Ðermanovic, M. Ranisavljevic, B. Gutic
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引用次数: 0

Abstract

Introduction: The ?gold standard? for patients with locally advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery. Aim: Evaluation of local recurrence after surgery for locally advanced rectal cancer. Methods and patients: Retrospective study included 189 patients, who were operated at Oncology Institute of Vojvodina from January 1st 2012 until December 31st 2017. Patients were divided into two groups. In the first group 73 patients who received chemoradiotherapy were included, while 116 patients without neoadjuvant treatment were in the second group. All patients were diagnosed with locally advanced rectal cancer. The existence of operable metastases in the liver and/or lungs did not exclude patients from the study. Patients who had undergone resection of the rectum by Miles, Hartmann or local tumor excision were excluded from the study. Results: The median follow-up period was 48 months (range 13-84). In total, 23 (12.2%) patients developed local recurrence. In the chemoradiotherapy group, 15.1% (11 of 73 patients) had a local recurrence, as compared with 10.3% (12 of 116 patients) in the group without neoadjuvant treatment. In both groups, there were no correlation between rate of local recurrence with other clinical and pathological parameters such as gender, tumor location, T and N stage, histological differentiation, or lymphovascular and perineural invasion (p>0.05). We confirmed significant association between circumferential resection margin with local recurrence in patients who were treated by preoperative chemoradiation (p=0.014). Conclusion: This study has not shown reduced risk of local recurrence after neoadjuvant therapy most likely due to small number of patients. Despite our results, neoadjuvant treatment followed by surgery remains the best treatment protocol for patients with locally advanced rectal cancer.
术前放化疗或不放化疗对局部晚期直肠癌术后局部复发的影响
导言:金本位?局部晚期直肠癌患者采用新辅助放化疗后手术治疗。目的:评价局部进展期直肠癌术后局部复发情况。方法和患者:回顾性研究纳入2012年1月1日至2017年12月31日在伏伊伏丁那肿瘤研究所手术的189例患者。患者分为两组。第一组73例接受放化疗的患者,第二组116例未接受新辅助治疗的患者。所有患者均被诊断为局部晚期直肠癌。肝脏和/或肺部可手术转移的存在并未将患者排除在研究之外。接受过Miles、Hartmann直肠切除术或局部肿瘤切除术的患者被排除在研究之外。结果:中位随访时间为48个月(范围13-84)。共有23例(12.2%)患者出现局部复发。在放化疗组,15.1%(73例患者中的11例)局部复发,而在没有新辅助治疗的组中,10.3%(116例患者中的12例)局部复发。两组局部复发率与其他临床病理参数如性别、肿瘤位置、T、N分期、组织学分化、淋巴血管及神经周围浸润等均无相关性(p < 0.05)。我们证实术前放化疗患者的环切缘与局部复发有显著相关性(p=0.014)。结论:本研究未显示新辅助治疗后局部复发风险降低,这很可能是由于患者数量少。尽管我们的结果,新辅助治疗后手术仍然是局部晚期直肠癌患者的最佳治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Archive of Oncology
Archive of Oncology Medicine-Oncology
CiteScore
0.60
自引率
0.00%
发文量
5
审稿时长
12 weeks
期刊介绍: Archive of Oncology is an international oncology journal that publishes original research, editorials, review articles, case (clinical) reports, and news from oncology (medical, surgical, radiation), experimental oncology, cancer epidemiology, and prevention. Letters are also welcomed. Archive of Oncology is covered by Biomedicina Vojvodina, Biomedicina Serbica, Biomedicina Oncologica, EMBASE/Excerpta Medica, ExtraMED and SCOPUS.
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