ABSTRACT
The objective of this study was to improve the immediate and long-term results of combined treatment of patients with locally advanced rectal cancer. The study included 128 patients with morphologically confirmed diagnosis and clinical stage cT3/T4 and N-/N+, treated from 1998 to 2009. The comparison group had 64 patients, combined treatment included prolonged preoperative radiotherapy 4 Gy and 40 Gy, surgery was performed after 4 weeks. In the study group--also 64 patients--combined treatment consisted of preoperative chemoradiotherapy (continuous a-120 hour infusion of 5-fluorouracil at a dose of 500 mg/m2 in the first and last week of radiotherapy in 2 Gy to 50 Gy), surgery was performed through 6 weeks after chemoradiotherapy. Excision of the primary tumor was performed in 40 (62.5%) patients in the control group and in 53 (82.8%) patients in the study group. Wherein R-0 resections were performed in 32 (67%) patients and in 41 (73%), and R-1 resections--in 1 (2%) patients, and 7 (13%) patients in the control and study groups respectively. A 5-year survival rate was 43.6 ± 7.2% control and 62.7 ± 5.1 % in the study group.
Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemoradiotherapy, Adjuvant , Neoadjuvant Therapy/methods , Rectal Neoplasms/pathology , Rectal Neoplasms/therapy , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Drug Administration Schedule , Female , Fluorouracil/administration & dosage , Follow-Up Studies , Humans , Infusions, Intravenous , Male , Middle Aged , Neoadjuvant Therapy/adverse effects , Neoplasm Staging , Rectal Neoplasms/surgery , Survival Analysis , Time Factors , Treatment OutcomeABSTRACT
Spread of the tumor in the distal direction is an important factor that must be considered when performing organ-serving surgery for rectal cancer. Particular relevance it has acquired in recent years due to the general tendency to expand the indications for the preservation of natural reflex-apparatus in patients with medium- and lower-ampullar part of the rectum.
Subject(s)
Anal Canal , Digestive System Surgical Procedures/methods , Organ Sparing Treatments , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Digestive System Surgical Procedures/trends , Humans , Neoplasm Recurrence, Local/prevention & control , Organ Sparing Treatments/methods , Rectal Neoplasms/prevention & controlABSTRACT
The pathomorphism of rectal cancer (RC) was studied in 99 patients who received neoadjuvant chemoradiotherapy using two drugs (5-fluorouracil and xeloda). A morphological study indicated the qualitatively similar manifestations of pathomorphism (tumor necrosis, inflammation, and sclerosis) which were more pronounced in the use of xeloda. Three degrees of the pathomorphism of RC have been identified: the tumor was unchanged, changed, and undetectable.
