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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2017

01-01-2017 | Colorectal Cancer

Patterns of Local Recurrence and Oncologic Outcomes in T3 Low Rectal Cancer (≤5 cm from the Anal Verge) Treated With Short-Course Radiotherapy With Delayed Surgery

Outcomes in T3 Low Rectal Cancer Treated With Short-Course Radiotherapy With Delayed Surgery

Authors: Naohito Beppu, MD, PhD, Fumihiko Kimura, MD, PhD, Tsukasa Aihara, MD, PhD, Hiroshi Doi, MD, PhD, Naohiro Tomita, MD, PhD, Hidenori Yanagi, MD, PhD, Naoki Yamanaka, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2017

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ABSTRACT

Background

Short-course radiotherapy with delayed surgery (SRT-delay) is still under clinical investigation for its efficacy in treating low rectal cancer (≤5 cm from the anal verge). This study was designed to assess the pattern of local recurrence and oncologic outcomes in T3 low rectal cancer treated with SRT-delay.

Methods

This study enrolled T3 low rectal cancer patients without distant metastasis between 2003 and 2015. All patients received total mesorectal excision following SRT-delay (25 Gy/10 fractions/5 days + S-1 radiosensitizer with a 4-week delay of surgery). The median follow-up period was 69 (range 1–149) months.

Results

A total 119 consecutive patients had low rectal cancer; 104 (87.4 %) underwent intersphincteric resection (ISR), and 15 (12.6 %) underwent abdominoperineal resection (APR). Fifty-six patients (47.1 %) were ypT-downstaged, 86 (72.2 %) were ypN0, and 10 (8.4 %) had circumferential resection margin involvement. The 5-year local recurrence-free survival, recurrence-free survival, and overall survival were 93.0, 76.2, and 80.5 %, respectively. Nine patients experienced local recurrence: lateral pelvic recurrence in six patients (5.0 %) and central pelvic recurrence in three (2.5 %).

Conclusions

A total of 87.4 % of sphincter-preserving surgeries were performed for T3 low rectal cancer following SRT-delay. Pathological tumor downstaging, circumferential resection margin involvement, local recurrence, and oncologic outcomes were acceptable; therefore, the SRT-delay regimen may be an option for treating T3 low rectal cancer.
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Metadata
Title
Patterns of Local Recurrence and Oncologic Outcomes in T3 Low Rectal Cancer (≤5 cm from the Anal Verge) Treated With Short-Course Radiotherapy With Delayed Surgery
Outcomes in T3 Low Rectal Cancer Treated With Short-Course Radiotherapy With Delayed Surgery
Authors
Naohito Beppu, MD, PhD
Fumihiko Kimura, MD, PhD
Tsukasa Aihara, MD, PhD
Hiroshi Doi, MD, PhD
Naohiro Tomita, MD, PhD
Hidenori Yanagi, MD, PhD
Naoki Yamanaka, MD, PhD
Publication date
01-01-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5604-6

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