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עמוד בית
Sun, 08.12.24

Original Articles

IMAJ | volume

Journal 6, June 2005
pages: 377-380

Treatment of Rectal Cancer by Chemoradiation followed by Surgery: Analysis and Early Clinical Outcome in 66 Patients

    Summary

     Background: Abdominoperineal resection entails the need for a permanent colostomy, which significantly reduces patient self-image and quality of life.

    Objective: To investigate the effectiveness of preoperative chemoradiation in increasing the resectability rates of rectal cancer and increasing the anal sphincter preservation rate.

    Methods: The study group included 66 patients aged 33–84 years with T2–T3 rectal carcinoma who were treated in our institute from 1997 to 2002 with preoperative chemoradiation followed by surgery 6 weeks later. All patients underwent preoperative transrectal endoscopic ultrasound for tumor staging and localization. The duration of follow-up was 25 months.

    Results: Chemoradiation led to tumor downstaging in 61 patients (92.4%), all of whom underwent low anterior resection. Only 11.4% of this group needed a temporary (6 weeks) loop colostomy/ileostomy. None of the 16 patients with post-treatment T0 tumors had evidence of malignant cells on pathologic study. Five patients (7.6%) failed to respond to chemoradiation and underwent APR[1]. There were no major complications, such as leakage, and no deaths.

    Conclusions: Neoadjuvant chemoradiation is an effective modality to downstage advanced rectal cancer, improving patient quality of life by significantly reducing the need for a terminal permanent colostomy, or even a temporary one.

     

    [1] APR = abdominoperineal resection

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