Отдаленные результаты хирургического и комбинированного лечения больных раком верхнеампулярного отдела прямой кишки

Abstract

Background. Сomparative assessment of long-term oncologic outcomes of surgical and combined treatment of patients with upper rectal cancer. Materials and methods. Patients aged > 18 with histologycally verified upper T1–4N0–2M0 rectal cancer were included. In group A patients received neoadjuvant chemoradiotherapy 25 Gy in 5 Gy fractions with capecitabine 850 mg/m2 bid per os on radiation days and surgery. In group B patients received surgery alone. Results. From january 2004 to december 2014, we selected 227 archival cases of patients with upper rectal cancer. Group A was 103 patients (45.4 %) in group B – 123 (54.6 %). We traced long-term results of treatment in 217 (96.6 %) patients. In the group A was 98 (95.1 %) patients, in the group B – 119 (96.7 %) patients. Local recurrence occurred in group A – 1 (1.2 %) patient, in group B – 3 (2.5 %) patients (p = 0.413). The frequency of distant metastases developed in group A in 10 (10.2 %) patients and in group B – 15 (12.6 %) patients (p = 0.581). Overall survival in group A was 90.6 %, and the disease-free survival – 89.6 %, in group B – 82.8 % and 81.9 %, respectively (p = 0.46). Conclusions. Surgical treatment of patients with upper rectal cancer stage I–III, in compliance with all oncological principles is justified.