The influence of pre-operative radiation therapy on the patterns of recurrence in rectal adenocarcinoma

✍ Scribed by Pedro Luna-Pérez; Saul Rodríguez-Ramírez; Jose González-Macouzet; Darío Francisco Rodríguez-Coria; Serafín Delgado; Marvin J. Lopez

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 79 KB
• Volume: 17
• Category: Article
• ISSN: 8756-0437
• DOI: 10.1002/(sici)1098-2388(199910/11)17:3<199::aid-ssu9>3.0.co;2-d

✦ Synopsis

we evaluated the institutional experience of local recurrence and survival in patients with rectal adenocarcinoma treated with pre-operative radiation therapy (PRT) as compared to those treated with radical surgery alone. There were 412 patients, divided into two groups: 259 patients (142 males and 117 females) in Group I and 153 patients (88 males and 65 females) in Group II. The median age was 56 years. Group I patients with locally advanced tumors, either tethered or fixed, received PRT at doses of 45 Gy delivered to the pelvis in two fields; 4 to 8 weeks later, radical surgery was performed. Patients with mobile tumors underwent radical surgery only (Group II). The operative mortality was 4.6% in Group I as compared to 1.9% in Group II (P = 0.18). At median follow-up of 89 months, there were local recurrences in 12.9% of Group I as compared to 36.2% in Group II (P = 0.0000001). The administration of PRT was associated with a low rate of local recurrence, but this improvement corresponded with a high morbidity rate, especially in patients who underwent abdominoperineal resection or pelvic exenteration.