Outcome of Local Excision Following Preoperative Chemoradiotherapy for Clinically T2 Distal Rectal Cancer: A Multicenter Retrospective Study (KROG 12-06).
- Author:
Jae Myoung NOH
1
;
Won PARK
;
Jae Sung KIM
;
Woong Sub KOOM
;
Jin Hee KIM
;
Doo Ho CHOI
;
Hee Chul PARK
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonro.park@samsung.com
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Rectal neoplasms;
Neoadjuvant therapy;
Local excision;
Complete remission
- MeSH:
Chemoradiotherapy*;
Disease-Free Survival;
Disulfiram;
Drug Therapy;
Fluorouracil;
Follow-Up Studies;
Humans;
Lymph Nodes;
Neoadjuvant Therapy;
Pelvis;
Radiotherapy;
Rectal Neoplasms*;
Recurrence;
Retrospective Studies*;
Capecitabine
- From:Cancer Research and Treatment
2014;46(3):243-249
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to examine the clinical implications of a pathologically complete response after neoadjuvant chemoradiotherapy (CRT) followed by local excision for patients with cT2 rectal cancer who refused radical surgery. MATERIALS AND METHODS: Seventeen patients with cT2 primary rectal cancer within 6 cm from the anal verge who received neoadjuvant CRT and local excision because of patient refusal of radical surgery or poor performance status were included. Two patients had clinical involvement of a regional lymph node. Preoperative radiotherapy was delivered to the whole pelvis at a dose of 44 to 50.4 Gy in 22 to 28 fractions. All patients underwent transanal excision and eight patients (47%) received postoperative chemotherapy. RESULTS: Ten patients (59%) achieved ypT0. At a median follow-up period of 75 months (range, 22 to 126 months), four (24%) patients developed recurrence (two locoregional and two distant). The 5-year disease-free survival of all patients was 82%, and was higher in patients with ypT0 (90%) than in patients with ypT1-2 (69%, p=0.1643). Decreased disease-free survival was also observed in patients receiving capecitabine compared with 5-fluorouracil (54% vs. 100%, p=0.0298). CONCLUSION: Local excision could be a feasible alternative to radical surgery in patients with ypT0 after neoadjuvant CRT for cT2 distal rectal cancer without further radical surgery.
