Factors influencing local recurrence after curative surgery for rectal cancer in special reference to external surgical margin (ew) and perineural invasion.

Nagawawa, Y.; Yanagita, K.; Nakamura, Hiroshi; Yasushi, Tatsuo; Thujita, K.; Gotoh, T.; Kuwabara, Taku; Andoh, Koh; Torigoshi, Takayoshi; Funahashi, Kimihiko; Watanabe, Kôji; Yamashita, Shintaro; Okano, Yoshifumi; Kobayashi, Kazuo; Ohgai, Tadahisa; Kuramoto, S; Terada, Yoshio; Thujimoto, S.

doi:10.3862/jcoloproctology.44.304

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“…The incidence of local recurrence after curative surgery for rectal carcinoma has been reported to range from 10% to 35%, [1][2][3][4][5][6][7][8][9] and remains a major source of mortality. 6,10 Apart from events such as suture line recurrence after sphincter-preserving operations, 11 the majority of patients who develop recurrent rectal carcinoma cannot undergo a curative reoperation, because the recurrent tumor has invaded either the pelvic wall or pelvic organs.…”

Section: Introductionmentioning

confidence: 99%

Improved outcome following preoperative radiochemotherapy: 40.5 Gy accelerated hyperfractionation and 5-fluorouracil suppositories for patients with carcinoma of the lower rectum

et al. 1999

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The aim of this study was to determine the long-term effects of administering preoperative radiochemotherapy to patients with carcinoma of the lower rectum. The outcomes of 29 patients who underwent curative surgery for carcinoma of the lower rectum after receiving radiochemotherapy in the form of 40.5 Gy accelerated hyperfractionation and a total dose of 3 400 mg 5-fluorouracil given as suppositories, with or without hyperthermia, and 48 patients who underwent surgery alone, were retrospectively compared. The tumors in all the patients were histologically diagnosed as stage T3. The cumulative 5-year survival rate and 5-year local recurrence-free rate of the patients treated with radiochemotherapy plus surgery were significantly better than those of the patients treated by surgery alone, the respective values being 80.5% vs 59.8% (P = 0.0325) and 95.7% vs 61.4% (P = 0.0041). Dehiscence of the perineal wound, anastomotic leakage, and postoperative ileus occurred at similar frequencies in both groups; however, perineal wound healing after abdominoperineal resection was delayed in the patients treated with radiochemotherapy plus surgery at 42.7 days vs 25.4 days (P = 0. 0062). In conclusion, although the wound healing was delayed, preoperative radiochemotherapy is considered to be beneficial for patients with carcinoma of the lower rectum.

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