Preoperative chemoradiation for rectal cancer: results of multimodality management and analysis of prognostic factors |
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Authors: | Shivnani Anand T Small William Stryker Steven J Kiel Krystyna D Lim Sherry Halverson Amy L Talamonti Mark S |
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Affiliation: | Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. |
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Abstract: | BACKGROUND: Our goals were to examine the impact of neoadjuvant chemoradiation for rectal cancer on surgical outcomes and to determine prognostic factors predicting improved survival. METHODS: Retrospective cohort of 56 male and 44 female patients. RESULTS: After preoperative chemoradiation, 73% of patients had sphincter-preserving surgery. The 5-year disease-free (DFS) and overall survival rates were 77% and 81%, respectively. Twenty-five percent of patients showed a complete pathologic response. T-level downstaging and pathologic T stage did not correlate with recurrence or survival rates. Pathologic nodal stage was associated with a significant difference in recurrence rates (N(0) 19%, N1 20%, and N2 75%, P = .038) and DFS (N0/N1 vs. N2, 79% vs. 25%, P = .002). CONCLUSION: Neoadjuvant chemoradiation resulted in a high rate of sphincter preservation. Complete pathologic responses after surgery were frequent and although pathologic T stage after surgery did not affect recurrence rates, pathologic nodal response was associated with improved recurrence and survival rates. |
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Keywords: | Neoadjuvant chemoradiation Rectal cancer Rectal surgery |
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