Preoperative chemoradiation for rectal cancer: results of multimodality management and analysis of prognostic factors

Anand T. Shivnani, William Small, Steven J. Stryker, Krystyna D. Kiel, Sherry Lim, Amy L Halverson, Mark S. Talamonti*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Background: Our goals were to examine the impact of neoadjuvant chemoradiation for rectal cancer on surgical outcomes and to determine prognostic factors predicting improved survival. Methods: Retrospective cohort of 56 male and 44 female patients. Results: After preoperative chemoradiation, 73% of patients had sphincter-preserving surgery. The 5-year disease-free (DFS) and overall survival rates were 77% and 81%, respectively. Twenty-five percent of patients showed a complete pathologic response. T-level downstaging and pathologic T stage did not correlate with recurrence or survival rates. Pathologic nodal stage was associated with a significant difference in recurrence rates (N0 19%, N1 20%, and N2 75%, P = .038) and DFS (N0/N1 vs. N2, 79% vs. 25%, P = .002). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)389-394
Number of pages6
JournalAmerican Journal of Surgery
Volume193
Issue number3
DOIs
StatePublished - Mar 1 2007

Keywords

  • Neoadjuvant chemoradiation
  • Rectal cancer
  • Rectal surgery

ASJC Scopus subject areas

  • Surgery

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