Cancer Res Treat.  2014 Apr;46(2):158-164.

Clinical Outcomes of Local Excision Following Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer

• Lee NK
• Kim DY
• Kim SY
• Oh JH
• Park W
• Choi DH
• Nam TK
• Lee KJ

Abstract

PURPOSE
To evaluate the treatment outcomes of local excision following preoperative chemoradiotherapy in patients with locally advanced rectal cancer who have not undergone radical surgery for any reason.
MATERIALS AND METHODS
The data of 27 patients with locally advanced rectal cancer who underwent preoperative chemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondary endpoint was the pattern of recurrence.
RESULTS
The median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and 85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patient had local recurrence only, three (11%) patients had distant recurrence only, and two (7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients with ypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6% (p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively.
CONCLUSION
Local excision following preoperative chemoradiotherapy may be an alternative treatment for highly selected patients with locally advanced rectal cancer who have achieved ypT0-1 after preoperative chemoradiotherapy.

Keyword

Rectal neoplasms; Local excision; Preoperative chemoradiotherapy; Survival

MeSH Terms

Chemoradiotherapy*
Follow-Up Studies
Humans
Rectal Neoplasms*
Recurrence
Retrospective Studies
Survival Rate
Treatment Failure

Figure

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  Fig. 1 Comparison of overall survival curves (p=0.073) (A) and relapse-free survival curves (p=0.051) (B) in patients stratified by ypT status (solid line, ypT0-1; dashed line, ypT2-3).

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  Fig. 2 Comparison of local recurrence-free survival curves (p=0.244) (A) and distant metastasis-free survival curves (p=0.016) (B) in patients stratified by ypT status (solid line, ypT0-1; dashed line, ypT2-3).

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