Radiat Oncol J.  2016 Sep;34(3):177-185. 10.3857/roj.2016.01872.

Preoperative chemoradiotherapy followed by local excision in clinical T2N0 rectal cancer

Affiliations
  • 1Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jhkim2@amc.seoul.kr
  • 2Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients.
MATERIALS AND METHODS
Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months.
RESULTS
All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting.
CONCLUSION
PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.

Keyword

Radiotherapy; Rectal neoplasms; Neoadjuvant therapy; Transanal endoscopic microsugery

MeSH Terms

Chemoradiotherapy*
Fistula
Follow-Up Studies
Humans
Minimally Invasive Surgical Procedures
Neoadjuvant Therapy
Polymerase Chain Reaction
Radiotherapy
Rectal Neoplasms*
Recurrence
Retrospective Studies
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