Clinical Outcomes of Local Excision Following Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer.
- Author:
Nam Kwon LEE
1
;
Dae Yong KIM
;
Sun Young KIM
;
Jae Hwan OH
;
Won PARK
;
Doo Ho CHOI
;
Taek Keun NAM
;
Kyung Ja LEE
Author Information
1. Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea. radiopiakim@hanmail.net
- Publication Type:Original Article
- Keywords:
Rectal neoplasms;
Local excision;
Preoperative chemoradiotherapy;
Survival
- MeSH:
Chemoradiotherapy*;
Follow-Up Studies;
Humans;
Rectal Neoplasms*;
Recurrence;
Retrospective Studies;
Survival Rate;
Treatment Failure
- From:Cancer Research and Treatment
2014;46(2):158-164
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the treatment outcomes of local excision following preoperative chemoradiotherapy in patients with locally advanced rectal cancer who have not undergone radical surgery for any reason. MATERIALS AND METHODS: The data of 27 patients with locally advanced rectal cancer who underwent preoperative chemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondary endpoint was the pattern of recurrence. RESULTS: The median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and 85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patient had local recurrence only, three (11%) patients had distant recurrence only, and two (7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients with ypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6% (p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively. CONCLUSION: Local excision following preoperative chemoradiotherapy may be an alternative treatment for highly selected patients with locally advanced rectal cancer who have achieved ypT0-1 after preoperative chemoradiotherapy.
