The impact of preoperative chemoradiotherapy on advanced low rectal cancer

Ping Sheng Kao, Shih Ching Chang, Ling Wei Wang, Rheun Chuan Lee, Wen Yi Liang, Tzu Chen Lin, Wei Shone Chen, Jeng Kai Jiang, Shung Haur Yang, Huann Sheng Wang, Jen Kou Lin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Background: Preoperative chemoradiotherapy (CCRT) followed by radical resection is an option for advanced low rectal cancer. This study was aimed to clarify the impact of CCRT on patients' outcome. Patients and Methods One hundred thirty-six patients with rectal cancer (<10 cm from anal verge) were enrolled prospectively between July 2000 and December 2004. The preoperative clinical stage was T3, T4, or node-positive disease. Sixty-nine and 67 patients underwent surgery with and without preoperative CCRT, respectively. The regimen of pre-op CCRT was a radiation dosage of Gy in 20 fractions and oral tegafur-uracil (UFUR) and leucovorin. Results There was no statistical difference in the preserved anorectal function between two groups after 5 years of follow-up (62.3% vs. 47.8%; P = 0.125). The 5-year overall survival and disease-free survival (DFS) percentage were 88.4% and 76.8% for patients with preoperative CCRT, and 65.7% and 58.2% for patients without CCRT, respectively. Patients with preoperative CCRT had a higher overall survival rate and DFS (P = 0.001 and 0.015). Conclusions In patients with advanced low rectal cancer, preoperative CCRT followed by radical surgery significantly improved overall survival and DFS compared with surgery alone. The effect of sphincter preservation with preoperative CCRT is questionable.

Original languageEnglish
Pages (from-to)771-777
Number of pages7
JournalJournal of Surgical Oncology
Volume102
Issue number7
DOIs
StatePublished - 1 Dec 2010

Keywords

  • CCRT
  • chemoradiotherapy
  • rectal cancer
  • sphincter preservation
  • survival

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