Local Recurrence in Patients with Upper Third Rectum Cancer Treated with Surgery Alone Compared with Surgery Plus Chemoradiotherapy

Abstract

Background: Colorectal cancer is the third most common neoplasm in Mexico, rectal cancer is the 16th most common neoplasm [1]. Due to the different behavior and prognostic factors of locally advance disease, manage should be tailored by a multidisciplinary approach. In tumors that rise in the upper third rectum cancer scenario there are no studies comparing the oncological results of multimodal treatment vs surgery alone. Objective: To compare the disease-free survival in patients with upper third rectal cancer treated with surgery alone vs multimodal treatment. Material and Methods: We conducted a descriptive, retrospective, longitudinal study using an historical cohort. Analysis was based from the information in patient`s records from diagnosed with cancer of the upper third rectum from 2011 to 2016. All patients with diagnosis of upper third rectum cancer were set in to two groups according to the treatment modality recited: Surgery alone and neoadjuvant chemotherapy. The records of patients diagnosed with cancer of the upper third rectum were reviewed and divided into two groups: with and without neoadjuvant chemoradiotherapy, both treated with surgery. Results: A total of 64 patient`s record were eligible, 48 of them were treated with surgery alone and 16 with a multimodal approach. The mean age was 65.5 years in those treated with surgery and 69 in the multimodal management group. The most frequent procedure was anterior resection, 45 cases (70.3%) in the group treated with surgery and 12 cases (18.7%) in the multimodal group. A case of complete pathological response was reported after a follow up of two years. Conclusion: The data suggests that there are no statistically significant differences in the local recurrence and disease-free survival with the use of neoadjuvant chemoradiotherapy.