Local excision after neoadjuvant chemoradiation therapy in advanced rectal cancer: a national multicenter analysis

Abstract

Background: The aim of the current study was to evaluate the clinical availability of local excision (LE) for advanced rectal cancer without lymph node metastasis after neoadjuvant chemoradiation therapy (nCRT) in Korea.

Methods: From June 2000 to October 2009, 40 patients with cT2-3N0M0 rectal cancer underwent nCRT followed by LE according to a retrospective multicenter analysis.

Results: Of the 40 patients, 22 were men and 18 were women. Eighteen patients were cT2, and 22 patients were cT3. The median follow-up duration was 38 months. Three patients (7.5%) had morbidity after LE. Four patients (10%) had recurrence (local recurrence [1 patient] and systemic metastasis [3 patients]). The 3-year disease-free survival rate was 85.9%. Only pCR was a recurrence-related prognostic factor (P = .040).

Conclusions: Although the current study was not a randomized controlled study, LE after nCRT in T2-3N0 rectal cancer patients appears to be a safe and effective treatment, especially in pCR patients.

Keywords: Local excision; Neoadjuvant chemoradiation therapy; Rectal cancer.