KMID : 1141920230390030250
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Annals of Coloproctology 2023 Volume.39 No. 3 p.250 ~ p.259
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Efficacy of preoperative chemoradiotherapy in patients with cT2N0 distal rectal cancer
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Park Min-Young
Yu Chang-Sik Kim Tae-Won Kim Jong-Hoon Park Jin-Hong Lee Jong-Lyul Yoon Yong-Sik Park In-Ja Lim Seok-Byung Kim Jin-Cheon
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Abstract
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Purpose : This study was designed to determine the feasibility of preoperative chemoradiotherapy (PCRT) in patients with clinical T2N0 distal rectal cancer.
Methods : Patients who underwent surgery for clinical T2N0 distal rectal cancer between January 2008 and December 2016 were included. Patients were divided into PCRT and non-PCRT groups. Non-PCRT patients underwent radical resection or local excision (LE) according to the surgeon¡¯s decision, and PCRT patients underwent surgery according to the response to PCRT. Patients received 50.0 to 50.4 gray of preoperative radiotherapy with concurrent chemotherapy.
Results : Of 127 patients enrolled, 46 underwent PCRT and 81 did not. The mean distance of lesions from the anal verge was lower in the PCRT group (P=0.004). The most frequent operation was transanal excision and ultralow anterior resection in the PCRT and non-PCRT groups, respectively. Of the 46 patients who underwent PCRT, 21 (45.7%) achieved pathologic complete response, including 15 of the 24 (62.5%) who underwent LE. Rectal sparing rate was significantly higher in the PCRT group (11.1% vs. 52.2%, P<0.001). There were no significant differences in 3- and 5-year overall survival and recurrence-free survival regardless of PCRT or surgical procedures.
Conclusion : PCRT in clinical T2N0 distal rectal cancer patients increased the rectal sparing rate via LE and showed acceptable oncologic outcomes. PCRT may be a feasible therapeutic option to avoid abdominoperineal resection in clinical T2N0 distal rectal cancer.
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KEYWORD
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Colorectal neoplasms, Preoperative chemoradiotherapy, Local excision, Survival
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