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01-05-2005 | Original Contribution

Preoperative Radiotherapy Improves Outcome in Recurrent Rectal Cancer

Authors: Maarten Vermaas, M.D., Floris T. J. Ferenschild, M.D., Joost J. M. E. Nuyttens, M.D., Ph.D., Andreas W. K. S. Marinelli, M.D., Ph.D., Theo Wiggers, M.D., Ph.D., Joost R. M. M. van der Sijp, M.D., Ph.D., Cornelis Verhoef, M.D., Wilfried J. Graveland, M.Sc., Alexander M. M. Eggermont, M.D., Ph.D., Johannes H. W. de Wilt, M.D., Ph.D.

Published in: Diseases of the Colon & Rectum | Issue 5/2005

PURPOSE

When local recurrent rectal cancer is diagnosed without signs of metastases, a potentially curative resection can be performed. This study was designed to compare the results of preoperative radiotherapy followed by surgery with surgery only.

METHODS

Between 1985 and 2003, 117 patients with recurrent rectal cancer were prospectively entered in our database. Ninety-two patients were suitable for resection with curative intent. Preoperative radiation with a median dosage of 50 Gy was performed in 59 patients; 33 patients did not receive preoperative radiotherapy. The median age of the patients was respectively 66 and 62 years.

RESULTS

The median follow-up of patients alive for the total group was 16 (range, 4–156) months. Tumor characteristics were comparable between the two groups. Complete resections were performed in 64 percent of the patients who received preoperative radiation and 45 percent of the nonirradiated patients. A complete response after radiotherapy was found in 10 percent of the preoperative irradiated patients (n = 6). There were no differences in morbidity and reintervention rate between the two groups. Local control after preoperative radiotherapy was statistically significantly higher after three and five years (P = 0.036). Overall survival and metastases-free survival were not different in both groups. Complete response to preoperative radiotherapy was predictive for an improved survival.

CONCLUSIONS

Preoperative radiotherapy for recurrent rectal cancer results in a higher number of complete resections and an improved local control compared with patients treated without radiotherapy. Preoperative radiotherapy should be standard treatment for patients with recurrent rectal cancer.

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Title: Preoperative Radiotherapy Improves Outcome in Recurrent Rectal Cancer
Authors: Maarten Vermaas, M.D.
Floris T. J. Ferenschild, M.D.
Joost J. M. E. Nuyttens, M.D., Ph.D.
Andreas W. K. S. Marinelli, M.D., Ph.D.
Theo Wiggers, M.D., Ph.D.
Joost R. M. M. van der Sijp, M.D., Ph.D.
Cornelis Verhoef, M.D.
Wilfried J. Graveland, M.Sc.
Alexander M. M. Eggermont, M.D., Ph.D.
Johannes H. W. de Wilt, M.D., Ph.D.
Publication date: 01-05-2005
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 5/2005
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-004-0891-6

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Preoperative Radiotherapy Improves Outcome in Recurrent Rectal Cancer

PURPOSE

METHODS

RESULTS

CONCLUSIONS

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PURPOSE

METHODS

RESULTS

CONCLUSIONS

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