Prognostic Impact of Upfront Surgery for Locally Advanced Upper Rectal Adenocarcinoma
- PMID: 34969721
- DOI: 10.21873/anticanres.15469
Prognostic Impact of Upfront Surgery for Locally Advanced Upper Rectal Adenocarcinoma
Abstract
Background/aim: Impact of neoadjuvant chemoradiotherapy (CRT) in locally advanced upper rectal adenocarcinoma (LAURC) is debated. The aim of this study was to compare outcomes between LAURC and locally advanced sigmoid and recto-sigmoid junction cancer (LASC).
Patients and methods: This retrospective study included 149 consecutive patients [42 CRT/LAURC, 16 upfront surgery (US/LAURC) and 91 LASC]. Partial mesorectum excision (PME) was performed for all LAURC. Pathology results as well as short-and-long-term outcomes were compared between the three groups.
Results: Overall mortality was nil. Morbidity was comparable (CRT/LAURC 23.8% vs. LASC: 20.8% vs. US/LAURC: 37.5%, p=0.2354). CRT was associated with a reduced risk of positive circumferential margin (CRT/LAURC: 9.5% vs. US/LAURC: 18.7%, p<0.0001). Recurrence rate, 5-year disease-free survival and overall survival were similar between the three groups.
Conclusion: CRT and PME did not improve LAURC oncological outcomes but were associated with improved margins. CRT for LAURC was not associated with increased morbidity.
Keywords: PME; Rectal cancer; neoadjuvant chemoradiotherapy; sigmoid cancer; upper rectum.
Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
MeSH terms
LinkOut - more resources
Full Text Sources
Research Materials