Impact of Pre-Operative Chemoradiotherapy on cT3N0M0 Middle and Low Rectal Cancer

Abstract

Purpose. To evaluate the oncological benefit of neoadjuvant concurrent Chemo-RadioTherapy (CCRT) for cT3N0M0 rectal cancer.Materials and Method. Between July 2000, and December 2004, 103 patients of middle and low rectal cancer with primary cT3N0M0 were enrolled. Of them, 37 patients were staged by magnetic resonance imaging (MRI), and 66 by computed tomography (CT); 80 patients did not receive pre-operative concurrent Chemo-RadioTherapy (CCRT) and 23 did. Radical resections were performed as the protocol. The oncological results including survival, local and distant metastasis rates were analyzed.Results. For the concurrent Chemo-RadioTherapy (CCRT) group, the complete response rate was 34.8% and the down staging rate was 73.9%. There was no significant difference in survival analysis between the two groups (OS: 91.3% vs. 82.1%; DFS: 86.4% vs. 79.5%; CSS: 91.3% vs. 91.0%), neither in local (10% vs. 4.3%) nor distant control (23.8% vs. 17.4%).Conclusion. Pre-operative concurrent Chemo-RadioTherapy (CCRT) might not provide better local control or survival benefit for cT3N0M0 middle and low rectal cancer.