Outcome of Local Excision Following Preoperative Chemoradiotherapy for Clinically T2 Distal Rectal Cancer: A Multicenter Retrospective Study (KROG 12-06)
- Jae Myoung Noh; Won Park; Jae-Sung Kim; Woong Sub Koom; Jin Hee Kim; Doo Ho Choi; Hee Chul Park
- Dept. of Radiation Oncology (방사선종양학)
- Issue Date
- Cancer Research and Treatment, Vol.46(3) : 243-249, 2014
- Purpose : The aim of this study was to examine the clinical implications of a pathologically complete response after neoadjuvant chemoradiotherapy (CRT) followed by local excision for patients with cT2 rectal cancer who refused radical surgery.
Materials and Methods : Seventeen patients with cT2 primary rectal cancer within 6 cm from the anal verge who received neoadjuvant CRT and local excision because of patient refusal of radical surgery or poor performance status were included. Two patients had clinical involvement of a regional lymph node. Preoperative radiotherapy was delivered to the whole pelvis at a dose of 44 to 50.4 Gy in 22 to 28 fractions. All patients underwent transanal excision and eight patients (47%) received postoperative chemotherapy.
Results : Ten patients (59%) achieved ypT0. At a median follow-up period of 75 months (range, 22 to 126 months), four (24%) patients developed recurrence (two locoregional and two distant). The 5-year disease-free survival of all patients was 82%, and was higher in patients with ypT0 (90%) than in patients with ypT1-2 (69%, p=0.1643). Decreased disease-free survival was also observed in patients receiving capecitabine compared with 5-fluorouracil (54% vs. 100%, p=0.0298).
Conclusion : Local excision could be a feasible alternative to radical surgery in patients with ypT0 after neoadjuvant CRT for cT2 distal rectal cancer without further radical surgery.
Key words: Rectal neoplasms, Neoadjuvant therapy, Local excision, Complete remission
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- 1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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