Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 14:14:607-612.
doi: 10.1515/med-2019-0068. eCollection 2019.

Colorectal Cancer in the Elderly Patient: The Role of Neo-adjuvant Therapy

Concetta Anna Dodaro  1 , Armando Calogero  1 , Vincenzo Tammaro  1 , Tommaso Pellegrino  1 , Ruggero Lionetti  2 , Silvia Campanile  1 , Marsela Menkulazi  1 , Massimo Ciccozzi  3 , Anna Maria Iannicelli  4 , Francesco Giallauria  4 , Caterina Sagnelli  5
Affiliations

Colorectal Cancer in the Elderly Patient: The Role of Neo-adjuvant Therapy

Concetta Anna Dodaro et al. Open Med (Wars). .

Abstract

Background: Neoadjuvant chemoradiotherapy has a significant role in downstaging cancer. It improves the local control of the disease and can make conservative resection of rectal cancer possible.

Methods: We enrolled 114 patients with subperitoneal rectal cancer who underwent neoadjuvant chemoradio-therapy and radical excision with total mesorectal excision (TME). The primary endpoint was oncological outcomes and the secondary endpoint was surgical outcomes.We evaluate the experience of a multidisciplinary team and the role of neoadjuvant chemoradiotherapy in integrated treatment of cancer of the subperitoneal rectum.

Results: Surgical procedures performed were abdominal perineal resection in 4 cases (3.5%), anterior resection in 89 cases (78%), Hartmann's procedure in 5 cases (4.4%), and ultralow resection with coloanal anastomosis and diverting stoma in 16 patients (14%).Local recurrence occurred in 6 patients (5.2%), the overall survival was 71.9% at 5 years and disease-free survival was about 60%.

Conclusions: The effect of pathological downstaging amounted to 58.8%, including cPR. The pathologic complete remission occurred in 8.8% of cases.The outcomes of neoadjuvant therapy can be achieved when this treatment is associated with correct surgical technique with TME and the prognosis is defined by an anatomopathological examination performed according to Quirke's protocol.

Keywords: Colorectal tumors; Neoadjuvant chemoradiotherapy; Rectal cancer.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The authors have no conflicts of interest (political, personal, religious, ideological, academic, intellectual, commercial or any other) to declare in relation to this manuscript.

References

    1. De Felice F, Daniela Musio D, Izzo L, Tombolini V. Neoadjuvant chemoradiotherapy for locally advanced rectal cancer: The debate continues. World J Gastrointest Oncol. 2014;6(15)(12):438. doi: 10.4251/wjgo.v6.i12.438. –. - DOI - PMC - PubMed
    1. Schrag D. Evolving role of neoadjuvant therapy in rectal cancer. Curr Treat Options Oncol. 2013;14(3):350. doi: 10.1007/s11864-013-242-248. –. - DOI - PubMed
    1. Boland PM, Fakin M. The emerging role of neoadjuvant chemotherapy for rectal cancer. J Gastrointest Oncol. 2014;5(5):362. doi: 10.3978/j.issn.2078-6891.2014.060. –. - DOI - PMC - PubMed
    1. Arnold D, Schmoll HJ. (Neo-)adjuvant treatments in colorectal cancer. Ann Oncol. 2005;16(2):ii133. –. - PubMed
    1. Kotake K, Koyama Y, Shida S, Tajima Y, Ishikawa H, Kanazawa K. Neo-adjuvant chemotherapy with carmofur for colorectal cancer--a multi-institutional randomized controlled study. Gan To Kagaku Ryoho. 2002;29(11):1917. et al. –. - PubMed

LinkOut - more resources