Effectiveness of preoperative chemoradiotherapy for advanced rectal cancer

Masaomi Yamane, Minoru Mizuta, Mitsumasa Kaji, Tatsuya Toyokawa, Katsuya Miyatani, Tetsunobu Udaka, Masatoshi Kubo, Nobuyuki Hosokawa, Kinichiro Suwaki, Kazutoyo Shirakawa

Research output: Contribution to journalArticlepeer-review

Abstract

To determine the pathologic effectiveness of preoperative chemoradiotherapy (CRT) in patients with advanced rectal carcinoma, we reviewed clinical records of 76 patients who received preoperative pelvic radiation +/- chemotherapy. Since 2 patients refused operation and 2 died before surgery, 72 patients underwent operation with a mean delay of 19.9 days after completion of irradiation. Pathologic tumor regression grade (Grade 0-3) was determined by the amount of viable tumor versus necrosis and fibrosis. Grade 0, 1 a, 1 b, 2, and 3 (pCR) were observed in 0%, 25.0%, 38.9%, 27.8% and 2.8% of patients, respectively. The pathologic response (PR) rate was 75.0% when PR was defined as greater than grade 1 b (tumor regression more than 1/3). Downstaging was observed in 35.8% of patients, in which 5-year overall survival was significantly better than in patients without downstaging (90.0% vs. 50.1%, p<0.05). No correlation could be observed between PR and downstaging. CRT is a useful tool with a high PR rate in patients with advanced rectal cancer. More accurate and careful clinical staging is important to select adequate candidates for CRT. Multi-institutional clinical trials as well as standardizing the surgical procedure including LN dissection are required to validate the advantages of CRT for Japanese patients.

Original languageEnglish
Pages (from-to)1441-1444
Number of pages4
JournalGan to kagaku ryoho. Cancer & chemotherapy
Volume33
Issue number10
Publication statusPublished - Oct 2006
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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