Advanced Carcinoma Of Rectum Research Articles

Dosimetric Study Comparing Three-Dimensional Conformal Radiotherapy to Intensity Modulated Radiotherapy in Management of Rectal Carcinoma. Retrospective study

Background: the External radiotherapy (EBRT) is the common treatment selection in patients with locally advanced rectum carcinoma. Three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are most techniques used in radiotherapy. However, which one is superior is all controversial. Patients and Methods: thirty-two patients of RC treated with IMRT were selected for current retrospective study. 3DCRT plans were also plan for all the patients. 3DCRT plans in compared to IMRT plans were on the basis of planning target volume (PTV) coverage, dose to normal organs, homogeneity index (HI) and conformity index (CI). Results and Discussions: in both the planning techniques 98% of PTV was covered with more than 96% of prescribed dose. D 95% 15, D 35 and D (Dose to 15%, 35% and 50% volume respectively) for bladder was reduced by 2.09%, 14.623% and 32.57% in IMRT compared to 3DCRT. V (Volume received 45 Gy also volume received 50.4Gy) and in case of bowel doses were found to be better in IMRT than to 3DCRT. There is significant difference found between doses to both femoral heads in IMRT and 3DCRT. The CI 95% 45 in IMRT plans was found much better than that in 3DCRT whereas HI in both the techniques were found almost same. Conclusion: IMRT in better significantly in reduction the irradiated of OAR and improved dose conformity in the PTV compared to that by 3DCRT. So, it can be concluded that IMRT should be chosen as best technique for the radiotherapy of Rectum carcinoma

Dosimetric Study Comparing Three-Dimensional Conformal Radiotherapy to Intensity Modulated Radiotherapy in Management of Rectal Carcinoma. Retrospective study

Background: the External radiotherapy (EBRT) is the common treatment selection in patients with locally advanced rectum carcinoma. Three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are most techniques used in radiotherapy. However, which one is superior is all controversial. Patients and Methods: thirty-two patients of RC treated with IMRT were selected for current retrospective study. 3DCRT plans were also plan for all the patients. 3DCRT plans in compared to IMRT plans were on the basis of planning target volume (PTV) coverage, dose to normal organs, homogeneity index (HI) and conformity index (CI). Results and Discussions: in both the planning techniques 98% of PTV was covered with more than 96% of prescribed dose. D 95% 15, D 35 and D (Dose to 15%, 35% and 50% volume respectively) for bladder was reduced by 2.09%, 14.623% and 32.57% in IMRT compared to 3DCRT. V (Volume received 45 Gy also volume received 50.4Gy) and in case of bowel doses were found to be better in IMRT than to 3DCRT. There is significant difference found between doses to both femoral heads in IMRT and 3DCRT. The CI 95% 45 in IMRT plans was found much better than that in 3DCRT whereas HI in both the techniques were found almost same. Conclusion: IMRT in better significantly in reduction the irradiated of OAR and improved dose conformity in the PTV compared to that by 3DCRT. So, it can be concluded that IMRT should be chosen as best technique for the radiotherapy of Rectum carcinoma

Screening colonoscopy and colorectal cancer: a single center long term study.

In Germany, colonoscopy has been introduced as a screening instrument more than 10 years ago. Immediate outcome (complications and adenoma detection) is well documented in a nation wide register, but there is only limited information on the decisive end points: long term incidence and mortality of colorectal carcinoma.We therefore tried to contact all those 495 subjects (296 women and 199 men, mean age 63.9 years) that had been screened between 2003 and 2005 at our institution. We were able to trace 472 persons (96 %), 5.1 to 7.8 years after colonoscopy; a total of 2730 person years were analysed. Data were collected by direct telephone calls and follow up colonoscopy reports were retrieved.Four malignant lesions were identified at screening. Another two colorectal carcinomas were diagnosed three and seven years after adenoma-negative colonoscopies: an advanced rectum carcinoma (index endoscopy described inadequate bowel preparation) and a coecum tumor. The patient with the rectum tumor subsequently died from the disease. The other five patients with colorectal carcinoma are disease-free. - Compliance with surveillance was limited, only 38 of 60 patients with advanced benign lesions and 49 out of 82 patients with a small tubular adenoma had a repeat colonoscopy, and this was performed a mean of 1.1 years later than advised. About half of the screened subjects were completely unaware of a recommended control interval or grossly wrong about it.We conclude that colorectal carcinomas can occur despite screening colonoscopy, but this seems to be a rare event. Subjects screened are insufficiently informed as to recommendations on post-polypectomy surveillance. This is particularly worrying in the high risk group with benign, but advanced adenomas.

Prognostic effects of clinical and pathologic TNM stages in patients with locally advanced rectum carcinoma after neoadjuvant chemoradiotherapy.

e14590 Background: To corroborate prognostic effects of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and ...

Total Laparoscopic Posterior Pelvic Exenteration

Posterior pelvic exenteration (PPE) has been used as modality of treatment for recurrent or primary cancer of rectum that has invaded into the female genital tract. We report a case of PPE performed for locoregionally advanced carcinoma of rectum invading the uterus; which was performed in a totally laparoscopic manner. The handsewn coloanal anastomosis was performed transrectally thus obviating the need for even a minilaparotomy for abdominal access for specimen retrieval or anastomotic stapler application. This is a first reported case in the literature where a total laparoscopic PPE was performed with successful outcome and oncological adequacy and safety.

Laparoscopic resection for rectal cancer: Outcomes in 194 patients and review of the literature

There are few reports on laparoscopic rectum resection demonstrating its feasibility and efficacy in patients with rectal cancer. Most patient series are small, and results must be considered preliminary and medium-term. Our large prospective conducted study aimed to assess the effectiveness of a totally laparoscopic resection for rectum carcinoma with emphasis on perioperative and long-term oncological outcomes. Between November 1992 and July 2003, 194 unselected patients were resected laparoscopically for rectal carcinoma. Patients with locally advanced rectum carcinoma (uT3/uT4) and no evidence of distant metastases were candidates for neoadjuvant chemoradiation. Adjuvant treatment was administered to patients with UICC stage II/III disease. All patients were followed up prospectively to evaluate complications and late outcomes. Survival probability analysis was performed using the Kaplan-Meier method. Study selection was made by Medline search using the following key words: rectal cancer, rectal neoplasms, laparoscopy, and resection. Single case reports and abstracts were excluded. When surgical series were reported more than once, only the most recent reports were considered and listed. The most common procedures were low anterior resection with total mesorectum excision in 65.5% of patients and high anterior resection in 25.3%. Average operative time was 174 min. Average number of lymph nodes removed was 25.4 and length of specimen resected was 27.6 cm. Resection was curative in 145 patients and palliative in 49 cases. UICC tumor stages were as follows: stage I: 25.2%, stage II: 27.3%, stage III: 30.4%, and stage IV: 17%. Intraoperative complications were <1% for lesions of the ureter, urinary bladder, and deferent duct. Conversion to conventional surgery was necessary in two cases (1%). The most common postoperative complication was anastomotic leakage in 13.5% of patients. There was no postoperative mortality. Follow-up evaluation ranged from 1 to 128 months with a mean of 46.1 months. The most common late complication was incisional hernia in 3.6% of patients. Port-site metastases occurred in one patient (0.5%). Tumor recurrence developed in 23 of the 145 curative resected patients (11.7% distant metastases and 4.1% local recurrence). Overall local recurrence rate was 6.7% (4.1% after curative resection and 14.3% after palliative resection). Overall survival rate was 90.6% at 1 year, 74.5% at 3 years, and 66.3% at 5 years. Overall 5-year survival rate was 76.9% after curative resection and 31.8% after palliative resection. Cancer-related survival rate was 94% at 1 year, 82.4% at 3 years, and 78.9% at 5 years. At 5 years it was 87.7% after curative resection and 48.5% after palliative resection. At 5 years, the survival rate was 100% for stage I, 94.4% for stage II, 66.6% for stage III, and 44.6% for stage IV. Our results and the literature review clearly demonstrate that laparoscopic resection for rectal cancer is not associated with higher morbidity and mortality. Established oncological and surgical principles are respected and long-term outcomes are at least as good as those after open surgery.

Observation of the curative effect from the treatment of locally advanced carcinoma of rectum by means of large-dosage preoperative radiotherapy and joint resection of the abdominal perineum

Objective To discuss the long term curative effect resulting from the treatment of local late\|stage carcinoma of the abdominal perineum.Methods We randomly divided 46 patients with local late\|stage carcinoma of rectum into two groups .Group one composed of 22 patients was treated by both large\|dosage radiotherapy and joint resection of the abdominal perineum.Group two of 24 patients was treated merely by resection of the abdominal perineum. The joint resection was performed after 4 to 5 weeks' rest. Group two received Miles' resection after a thorough preoperative preparation .Results The result indicated that the two groups showed significant difference in terms of resection rate (χ 2=5073, P 0.05).The lymoh node metastasis rate of the two groups had no significant difference.The 3\|year and 5\|year relapse rates showed that the two groups had signficant difference,The difference of the 1\|year,3\|year and 5\|year survival rates betweenthe two guoups was significant.Conclusion The result showed that the resection of the abdominal perineum after large\|dosage preoperative radiotherapy was of significance.