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Outcome of Local Excision Following Preoperative Chemoradiotherapy for Clinically 12 Distal Rectal Cancer: A Multicenter Retrospective Study (KROG 12-06)

Authors
 Jae Myoung Noh  ;  Won Park  ;  Jae-Sung Kim  ;  Woong Sub Koom  ;  Jin Hee Kim  ;  Doo Ho Choi  ;  Hee Chul Park 
Citation
 CANCER RESEARCH AND TREATMENT, Vol.46(3) : 243-249, 2014 
Journal Title
 CANCER RESEARCH AND TREATMENT 
ISSN
 1598-2998 
Issue Date
2014
Keywords
Rectal neoplasms ; Neoadjuvant therapy ; Local excision ; Complete remission
Abstract
PURPOSE: The aim of this study was to examine the clinical implications of a pathologically complete response after neoadjuvant chemoradiotherapy (CRT) followed by local excision for patients with cT2 rectal cancer who refused radical surgery. MATERIALS AND METHODS: Seventeen patients with cT2 primary rectal cancer within 6 cm from the anal verge who received neoadjuvant CRT and local excision because of patient refusal of radical surgery or poor performance status were included. Two patients had clinical involvement of a regional lymph node. Preoperative radiotherapy was delivered to the whole pelvis at a dose of 44 to 50.4 Gy in 22 to 28 fractions. All patients underwent transanal excision and eight patients (47%) received postoperative chemotherapy. RESULTS: Ten patients (59%) achieved ypT0. At a median follow-up period of 75 months (range, 22 to 126 months), four (24%) patients developed recurrence (two locoregional and two distant). The 5-year disease-free survival of all patients was 82%, and was higher in patients with ypT0 (90%) than in patients with ypT1-2 (69%, p=0.1643). Decreased disease-free survival was also observed in patients receiving capecitabine compared with 5-fluorouracil (54% vs. 100%, p=0.0298). CONCLUSION: Local excision could be a feasible alternative to radical surgery in patients with ypT0 after neoadjuvant CRT for cT2 distal rectal cancer without further radical surgery.
Files in This Item:
T201403224.pdf Download
DOI
10.4143/crt.2014.46.3.243
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99797
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