Results of management in multimodality of rectal cancer

ABSTRACT

Colorectal cancer is the second most common cause of cancer death in men and women. Our goals were to examine the impact of neoadjuvant chemoradiation for rectal cancer on surgical outcomes and to determine prognostic factors predicting improved survival. This prospective study has been completed on 50 patients with cancer rectum 28 male and 22 female. The mean age of all patients 61 years ranged from 24-86 years. The most common symptoms were rectal bleeding 84% followed by change in bowel habits 56% and weight loss 16% more than 50% of patients had more than one symptom. Tumour location was lower rectum 64% middle rectum 32% and upper rectum 4% after preoperative chemoradiation 73% of patients had sphincter-preserving surgery, the 3 year disease free survival [DFS] and over all survival were 77% and 81% respectively. Twenty-four percent of patients showed a complete pathologic response. T-level down staging and pathologic T-stage did not correlate with recurrence or survival rates. Pathologic nodal stage was associated with a significant differences in recurrence rates [No 19% N1 20%, N2 75% =p 0.038] and DFS [No/N1 vs. N2, 79% vs. 25% p=0.002]. 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