International Journal of Surgery and Surgical Sciences (IJSSS)
Open Access
Subscription Access
THE OUTCOME OF NEOADJUVANT CHEMO RADIOTHERAPY AND SURGERY IN CARCINOMA RECTUM - OUR EXPERIENCE
Abstract
Introduction: Carcinoma of the rectum is not only a medical but a social problem. Adenocarcinoma of the rectum accounts for 30% of these cancers. Locally advanced cancers of the rectum, i.e. stage 2 and 3 diseases prove to be a challenge with respect to its management. Present guidelines state that the use of neoadjuvant chemoradiotherapy to downstage the locally advanced carcinomas of the rectum to have a positive impact on not only the survival but also the quality of life post-treatment viz., by allowing better resection margins to preserve the sphincter mechanism by performing a coloanal anastomosis.
Objectives: To assess the locoregional response rates determined by the measurement of margin of clearance from the anal verge, organ preservation (sphincter-saving operations), and histopathological findings in post CRT surgical specimen.
Materials and Methods: This study included a total of 33 patients which were diagnosed with locally advanced rectal cancer who presented in the department of General Surgery, Vydehi Hospital, Bangalore. The patients in this series were subjected to pre-operative CRT, loco-regional response rates and the number of sphincter-preserving surgeries performed were assessed.
Results: Downstaging of the tumor was achieved in 91% of the cases.
Conclusion: From this study, an interpretation can be made that following CRT there is a significant downstaging and increased ability to perform sphincter-saving procedures.
Keywords
References
DeVita VT, Lawrence TS, and Rosenberg SA. (2008). “DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology”, 8th Edition, Lippincott Williams & Wilkins.
Garajová I, Di Girolamo S, and de Rosa F, et al. (2011). “Neoadjuvant Treatment in Rectal Cancer: Actual Status”, Chemotherapy Research and Practice, Vol.2011, Article ID 839742, 12 pages, available online: https://www.hindawi.com/journals/cherp/2011/839742/, doi:10.1155/2011/839742
Halder SK, Bhattacharjee PK, and Bhar P, et al. (2013). “Epidemiological, Clinico-Pathological Profile and Management of Colorectal Carcinoma in a Tertiary Referral Centre of Eastern India”, JKIMSU, Vol.2(1), pp.45-50, available online: http://www.jkimsu.com/jkimsu-vol2no1/jkimsu,%20vol%202,%20no%201,%20jan%20-%20june%202013,%2045-50.pdf
Hamilton W, Round A, Sharp D, and Peters TJ. (2005). “Clinical features of colorectal cancer before diagnosis: a population-based case-control study”, Br J Cancer, Vol.93(4), pp.399-405, available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361578/, doi:10.1038/sj.bjc.6602714
Ibrahim KO, Anjorin AS, Afolayan AE, and Badmos KB. (2011). “Morphology of colorectal carcinoma among Nigerians: A 30 year review”, Nigerian Journal of Clinical Practice, Oct-Dec, Vol.14(4), pp.432-435.
Laishram RS, Kaiho N, Shimray R, and Devi SB, et al. (2010). “Histopathological Evaluation of Colorectal Carcinomas Status in Manipur, India”, International Journal of Pathology, Vol.8(1), pp.5-8.
Onaitis MW, Noone RB, and Hartwig M. et al. (2001). “Neoadjuvant Chemoradiation for Rectal Cancer: Analysis of Clinical Outcomes From a 13-Year Institutional Experience”, Annals of surgery, Vol.233(6), pp.778-785.
Paun BC, Cassie S, and MacLean AR, et al. (2010). “Postoperative complications following surgery for rectal cancer”, Ann Surg, May, Vol.251(5), pp.807-818, available online: https://www.ncbi.nlm.nih.gov/pubmed/20395841, doi: 10.1097/SLA.0b013e3181dae4ed
Townsend CM Jr, Beauchamp RD, Evers BM, and Mattox KL. (2012). “Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice”, 19th Edition, Elsevier.
Wen B, Zhang L, Wang C, and Huang R, et al. (2015). “Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy”, Radiation Oncology, Vol.10, p.124, available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490617/, doi:10.1186/s13014-015-0425-5
Williams N, Bulstrode C, and O'Connell PR. (eds). (2013). “Bailey & Love‘s Short Practice of Surgery”, 26th Edition, CRC Press.
Xiao Y, Wu B, Qiu H, Xiong G, Lin G, Zhong G, Hu K, and Pan W. (2014). “Effects of tumor distance from anal verge and types of operations on survival outcomes for low rectal cancer after neoadjuvant chemoradiotherapy”, Zhonghua Yi Xue Za Zhi, June, Vol.94(22), pp.1705-1709, available online: https://www.ncbi.nlm.nih.gov/pubmed/25151899
Yeo CJ, Peters JH, Dempsey DT, Klein AS, and Pemberton JH. (2002). “Shackelford's Surgery of the Alimentary Tract”, 6th Edition, Elsevier.
Refbacks
- There are currently no refbacks.
Send mail to ijsss@ijsss.com with questions or comments about this web site.
International Journal of Surgery and Surgical Sciences, All rights reserved.