Abstract
BackgroundNeoadjuvant chemoradiotherapy has a significant role in downstaging cancer. It improves the local control of the disease and can make conservative resection of rectal cancer possible.MethodsWe enrolled 114 patients with subperitoneal rectal cancer who underwent neoadjuvant chemoradio-therapy and radical excision with total mesorectal excision (TME). The primary endpoint was oncological outcomes and the secondary endpoint was surgical outcomes.We evaluate the experience of a multidisciplinary team and the role of neoadjuvant chemoradiotherapy in integrated treatment of cancer of the subperitoneal rectum.ResultsSurgical procedures performed were abdominal perineal resection in 4 cases (3.5%), anterior resection in 89 cases (78%), Hartmann’s procedure in 5 cases (4.4%), and ultralow resection with coloanal anastomosis and diverting stoma in 16 patients (14%).Local recurrence occurred in 6 patients (5.2%), the overall survival was 71.9% at 5 years and disease-free survival was about 60%.ConclusionsThe effect of pathological downstaging amounted to 58.8%, including cPR. The pathologic complete remission occurred in 8.8% of cases.The outcomes of neoadjuvant therapy can be achieved when this treatment is associated with correct surgical technique with TME and the prognosis is defined by an anatomopathological examination performed according to Quirke’s protocol.
Highlights
Over the past two decades, outcomes in the management of rectal cancer have improved thanks to a multidisciplinary approach that involves the surgeon, pathologist, radiotherapist and oncologist
The outcomes of neoadjuvant therapy can be achieved when this treatment is associated with correct surgical technique with total mesorectal excision (TME) and the prognosis is defined by an anatomopathological examination performed according to Quirke’s protocol
There have been continuous efforts to improve local control and long-term survival in patients with rectal cancer, and the introduction of neoadjuvant therapy protocols in the treatment of this tumor has permitted the downstaging of the neoplasm in many cases
Summary
Continuous infusion i.v. with elastomeric pump of 5-fluorouracil at dose of 225 mg/m2 for the duration of the radia-. From January 2004 to December 2013 at our center were admitted 376 patients (206 male and 170 females) with colorectal cancer in an observational real-life retrospective study. Of these 376, 189 patients had adenocarcinomas of the colon and 187 patients had adenocarcinomas of the rectum. 150 patients showed a cancer of the rectum localized in the subperitoneal space (
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
