Clinical Outcomes of Local Excision Following Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer
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PurposeTo evaluate the treatment outcomes of local excision following preoperative chemoradiotherapyin patients with locally advanced rectal cancer who have not undergoneradical surgery for any reason. Materials and MethodsThe data of 27 patients with locally advanced rectal cancer who underwent preoperativechemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondaryendpoint was the pattern of recurrence. ResultsThe median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS),relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patienthad local recurrence only, three (11%) patients had distant recurrence only, and two(7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients withypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6%(p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively. ConclusionLocal excision following preoperative chemoradiotherapy may be an alternative treatmentfor highly selected patients with locally advanced rectal cancer who haveachieved ypT0-1 after preoperative chemoradiotherapy.
Abstract
PurposeTo evaluate the treatment outcomes of local excision following preoperative chemoradiotherapyin patients with locally advanced rectal cancer who have not undergoneradical surgery for any reason. Materials and MethodsThe data of 27 patients with locally advanced rectal cancer who underwent preoperativechemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondaryendpoint was the pattern of recurrence. ResultsThe median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS),relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patienthad local recurrence only, three (11%) patients had distant recurrence only, and two(7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients withypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6%(p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively. ConclusionLocal excision following preoperative chemoradiotherapy may be an alternative treatmentfor highly selected patients with locally advanced rectal cancer who haveachieved ypT0-1 after preoperative chemoradiotherapy.
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