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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2010

Open Access 01-12-2010 | Research

Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers

Authors: Yon Kuei Lim, Wai Lun Law, Rico Liu, Jensen TC Poon, Joe FM Fan, Oswens SH Lo

Published in: World Journal of Surgical Oncology | Issue 1/2010

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Abstract

Background

This study reviewed the impact of pre-operative chemoradiotherapy or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME) for ultralow rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR). We examined surgical complications, local recurrence and survival.

Methods

Of the 1270 patients who underwent radical resection for rectal cancer from 1994 till 2007, 180 with tumors within 4 cm with either peranal coloanal anastomosis or APR were analyzed. Patients were compared in groups that had surgery only (Group A), pre-operative chemoradiotherapy (Group B), and post-operative therapy (Group C).

Results

There were 115 males and the mean age was 65.43 years (range 30-89). APR was performed in 134 patients while 46 had a sphincter-preserving resection with peranal coloanal anastomosis. The mean follow-up period was 52.98 months (range: 0.57 to 178.9). There were 69, 58 and 53 patients in Groups A, B, and C, respectively. Nine patients in Group B could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Group A vs. 29.3% in Group B vs. 39.6% in Group C, respectively. The local recurrence rate was significantly lower in Group B (8.6.9% vs. 21.7% in Group A vs. 33.9% in Group C) p < 0.05. The 5-year cancer-specific survival rates for Group A was 49.3%, Group B was 69.9% and Group C was 38.8% (p = 0.14).

Conclusion

Pre-operative chemoradiation in low rectal cancer is not associated with a higher incidence of peri-operative complications and its benefits may include reduction local recurrence.
Appendix
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Metadata
Title
Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers
Authors
Yon Kuei Lim
Wai Lun Law
Rico Liu
Jensen TC Poon
Joe FM Fan
Oswens SH Lo
Publication date
01-12-2010
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2010
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-8-23

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