Efficacy of preoperative short course radiotherapy before laparoscopic radical resection for middle and low locally advanced rectal cancer / 中华普通外科杂志

ABSTRACT

Objective To analyse the effect with or without short course radiotherapy before laparoscopc surgery for middle and low locally advanced rectal cancer.Methods Clinical and pathological data of 145 patients confirmed with stage T3 or T4 middle and low locally advanced rectal cancer by pathology were retrospectively analyzed.69 cases were in preoperative short course radiotherapy group and 76 cases went directly to laparoscopic surgery.Results There was no statistical difference in the operation time,(140 ± 17) min vs.(136 ± 17) min,t =-3.04,P =0.761,for blood loss,(65 ±38)ml vs.(76 ±33)ml,t =-1.72,P =0.086.Less abdominal perineal resection was performed in preoperative short term radiotherapy group than in upfront surgery group,though the difference was not statistically significant (P =0.600).Postoperative complications were 16％ and 16％ respectively,x2 =0.001,P =0.98.The 2 year local recurrence rate was 6％ and 17％ respectively,x2 =2.246,P =0.035.There was no significant difference in 2 year distant metastasis rate between the two groups,x2 =0.000,P =0.99,nor the difference in 2 year's survival rate,87％ vs.87％,x2 =0.000,P =0.986.Conclusions Preoperative short course radiotherapy can reduce the local recurrence rate of middle and low locally advanced rectal cancer,without increasing the difficulty of operation and postoperative complications,but long time survival fails to improve.