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.
Highlights
Colorectal cancer is a frequent disease and represented in 2018 the third most common neoplasm in males and the second in females, with 1.8 million new cases and almost 861,000 deaths in 2018, according to the World Health Organization [1]
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
We reviewed the records of an historical cohort from the HGO XXI Century Oncology Research Unit, Oncology Hospital, Siglo XXI Medical Center IMSS, that included the patients diagnosed with cancer of the upper third rectum from 2011 to 2016 [14,15,16]
Summary
Colorectal cancer is a frequent disease and represented in 2018 the third most common neoplasm in males and the second in females, with 1.8 million new cases and almost 861,000 deaths in 2018, according to the World Health Organization [1]. In the United States, 145,600 new cases are diagnosed annually, of which 44,180 correspond to the rectum This disease accounts for approximately 8 percent of all cancer deaths [2]. The rectum is anatomically defined as the last 16 cm of large intestine from the anal canal and is covered by a fatty tissue that contains its closest regional lymph nodes It is richly vascularized and is surrounded by a thin membrane that corresponds to the mesorecta fascia, whose surgical resection must be complete to achieve adequate regional lymphadenectomy and ensure a microscopic margin free of neoplastic cells. Objective: To compare the disease-free survival in patients with upper third rectal cancer treated with surgery alone vs multimodal treatment. 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. 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
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