Abstract
OBJECTIVE: TO evaluate oncological and surgical outcome of patients submitted to neoadjuvant therapy for advanced rectal cancer. PATIENTS AND METHOD: One hundred thirty eight patients (86 male, 52 female, mean age 61.4 years), with tumour of lower (58; 42%), middle (66; 48%), upper rectum (14; 10%), showing a clinical stage II (23; 17%) or III (115; 83%) and with an average distance from anal verge of 6.5 cm, submitted to fractionated "long-course" RT with CT, locally staged by US and MR before and after neoadjuvant therapy and operated on after 4-6 weeks by its end. RESULTS: Surgical procedures (71 of which laparoscopic) were: 114 AR (83.8%), 19 APR (14%) and 3 TEM (2.2%). Mean nodal-sampling was 14.9. A complete or partial response was observed in 48.5% of the patients (67/138). With a mean follow-up of 30 months, local recurrence rate was 5.7%. Five-years overall survival and disease-free-survival were respectively 73% and 60%. DISCUSSION: We observed a significant clinical (p <0.004) and pathological (p <0.005) downstaging Pre-treatment clinical stage was not significant. On the contrary, postoperative y TNM was significant for yT (p <0.001) and yN (p <0.0003). Non-responder patients had worse prognosis (5-years survival 30%). The variable with higher prognostic significance was yN (p <0.0003), especially if we distinguish N1 by N2 (p <0.0004). CONCLUSIONS: The response to neoadjuvant therapy represents a significant prognostic variable.
| Original language | English |
|---|---|
| Pages (from-to) | 493-498 |
| Number of pages | 6 |
| Journal | Annali Italiani di Chirurgia |
| Volume | 78 |
| Issue number | 6 |
| Publication status | Published - Nov 2007 |
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Keywords
- Neoadjuvant therapy
- Rectal cancer
ASJC Scopus subject areas
- Surgery
Cite this
The role of the neoadjuvant chemotherapy in the treatment of the tumor of rectal cancer. / Staudacher, Carlo; Di Palo, Saverio; Tamburini, Andrea Marco; Vignali, Andrea; Orsenigo, Elena.
In: Annali Italiani di Chirurgia, Vol. 78, No. 6, 11.2007, p. 493-498.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The role of the neoadjuvant chemotherapy in the treatment of the tumor of rectal cancer
AU - Staudacher, Carlo
AU - Di Palo, Saverio
AU - Tamburini, Andrea Marco
AU - Vignali, Andrea
AU - Orsenigo, Elena
PY - 2007/11
Y1 - 2007/11
N2 - OBJECTIVE: TO evaluate oncological and surgical outcome of patients submitted to neoadjuvant therapy for advanced rectal cancer. PATIENTS AND METHOD: One hundred thirty eight patients (86 male, 52 female, mean age 61.4 years), with tumour of lower (58; 42%), middle (66; 48%), upper rectum (14; 10%), showing a clinical stage II (23; 17%) or III (115; 83%) and with an average distance from anal verge of 6.5 cm, submitted to fractionated "long-course" RT with CT, locally staged by US and MR before and after neoadjuvant therapy and operated on after 4-6 weeks by its end. RESULTS: Surgical procedures (71 of which laparoscopic) were: 114 AR (83.8%), 19 APR (14%) and 3 TEM (2.2%). Mean nodal-sampling was 14.9. A complete or partial response was observed in 48.5% of the patients (67/138). With a mean follow-up of 30 months, local recurrence rate was 5.7%. Five-years overall survival and disease-free-survival were respectively 73% and 60%. DISCUSSION: We observed a significant clinical (p <0.004) and pathological (p <0.005) downstaging Pre-treatment clinical stage was not significant. On the contrary, postoperative y TNM was significant for yT (p <0.001) and yN (p <0.0003). Non-responder patients had worse prognosis (5-years survival 30%). The variable with higher prognostic significance was yN (p <0.0003), especially if we distinguish N1 by N2 (p <0.0004). CONCLUSIONS: The response to neoadjuvant therapy represents a significant prognostic variable.
AB - OBJECTIVE: TO evaluate oncological and surgical outcome of patients submitted to neoadjuvant therapy for advanced rectal cancer. PATIENTS AND METHOD: One hundred thirty eight patients (86 male, 52 female, mean age 61.4 years), with tumour of lower (58; 42%), middle (66; 48%), upper rectum (14; 10%), showing a clinical stage II (23; 17%) or III (115; 83%) and with an average distance from anal verge of 6.5 cm, submitted to fractionated "long-course" RT with CT, locally staged by US and MR before and after neoadjuvant therapy and operated on after 4-6 weeks by its end. RESULTS: Surgical procedures (71 of which laparoscopic) were: 114 AR (83.8%), 19 APR (14%) and 3 TEM (2.2%). Mean nodal-sampling was 14.9. A complete or partial response was observed in 48.5% of the patients (67/138). With a mean follow-up of 30 months, local recurrence rate was 5.7%. Five-years overall survival and disease-free-survival were respectively 73% and 60%. DISCUSSION: We observed a significant clinical (p <0.004) and pathological (p <0.005) downstaging Pre-treatment clinical stage was not significant. On the contrary, postoperative y TNM was significant for yT (p <0.001) and yN (p <0.0003). Non-responder patients had worse prognosis (5-years survival 30%). The variable with higher prognostic significance was yN (p <0.0003), especially if we distinguish N1 by N2 (p <0.0004). CONCLUSIONS: The response to neoadjuvant therapy represents a significant prognostic variable.
KW - Neoadjuvant therapy
KW - Rectal cancer
UR - http://www.scopus.com/inward/record.url?scp=47249153145&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=47249153145&partnerID=8YFLogxK
M3 - Article
C2 - 18510028
AN - SCOPUS:47249153145
VL - 78
SP - 493
EP - 498
JO - Annali Italiani di Chirurgia
JF - Annali Italiani di Chirurgia
SN - 0003-469X
IS - 6
ER -