Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
Background. The need of neoadjuvant treatment for upper rectal cancer remains the object of discussion, which makes further study of this topic important.Аim. To estimate the postoperative complications rate depending on the type of neoajuvant treatment.Materials and methods. A retrospective cohort multicenter study, that analyzed data of medical records of patients with upper rectal cancer from the archive of N.N. Blokhin Cancer Research Center of the ministry of Health of Russia, Ryzhikh national medical Research Center of Coloproctology of the ministry of Health of Russia and Stavropol Regional Clinical Oncology Center for 2007–2020. Patients were devided into 3 groups: the group of radiotherapy (5*5 gy), the group of neoadjuvant chemotherapy (4 courses of XELOX before surgery) and the group of surgery. The main endpoint was the study of anastomotic leak rate. Also we estimated the postoperative complications rate III–Iv degree (Clavien– Dindo), the sphincter-preserving surgery rate, the stoma creation rate, the postoperative mortality.Results. we included 110 patients in radiotherapy group, 188 patients in neoadjuvant chemotherapy group, 103 patients in surgery group. Study groups were comparable by sex, ASA status and histological grade. Postoperative grade III– Iv complications (in all cases were associated with anastomotic leak) developed in 8 (6.8 %) patients in neoadjuvant chemotherapy group versus 11 (10.0 %) patients in radiotherapy group (p = 0.379) and 12 (11.7 %) patients in surgery group (p = 0.208). There weren»t any significant differences in this parameter between the radiotherapy and the surgery group (p = 0.698). R0-resection was performed in 117 (99.2 %) patients in neoadjuvant chemotherapy group versus 107 (97.3 %) patients in radiotherapy group (p = 0.280) and 103 patients (100 %) in surgery group (p = 0.349). Radiotherapy and surgery groups didn’t differ significantly in R0-resection rate (p = 0.091). 1 patient (0.84 %) in neoadjuvant chemotherapy died before surgery, in other groups there weren’t any lethal outcomes (p = 0.283). Only the male sex, had a statistically significant effect on the anastomotic leak rate (risk ratio (HR) 2.875; 95 % confidence interval (CI) 1.24–6.63; p = 0.003).Conclusions. A study of these case histories of patients with cancer of the upper ampullary rectum, conducted by us, showed that neoadjuvant treatment didn»t affect the postoperative complications rate.
Background. The need of neoadjuvant treatment for upper rectal cancer remains the object of discussion, which makes further study of this topic important.Аim. To estimate the postoperative complications rate depending on the type of neoajuvant treatment.Materials and methods. A retrospective cohort multicenter study, that analyzed data of medical records of patients with upper rectal cancer from the archive of N.N. Blokhin Cancer Research Center of the ministry of Health of Russia, Ryzhikh national medical Research Center of Coloproctology of the ministry of Health of Russia and Stavropol Regional Clinical Oncology Center for 2007–2020. Patients were devided into 3 groups: the group of radiotherapy (5*5 gy), the group of neoadjuvant chemotherapy (4 courses of XELOX before surgery) and the group of surgery. The main endpoint was the study of anastomotic leak rate. Also we estimated the postoperative complications rate III–Iv degree (Clavien– Dindo), the sphincter-preserving surgery rate, the stoma creation rate, the postoperative mortality.Results. we included 110 patients in radiotherapy group, 188 patients in neoadjuvant chemotherapy group, 103 patients in surgery group. Study groups were comparable by sex, ASA status and histological grade. Postoperative grade III– Iv complications (in all cases were associated with anastomotic leak) developed in 8 (6.8 %) patients in neoadjuvant chemotherapy group versus 11 (10.0 %) patients in radiotherapy group (p = 0.379) and 12 (11.7 %) patients in surgery group (p = 0.208). There weren»t any significant differences in this parameter between the radiotherapy and the surgery group (p = 0.698). R0-resection was performed in 117 (99.2 %) patients in neoadjuvant chemotherapy group versus 107 (97.3 %) patients in radiotherapy group (p = 0.280) and 103 patients (100 %) in surgery group (p = 0.349). Radiotherapy and surgery groups didn’t differ significantly in R0-resection rate (p = 0.091). 1 patient (0.84 %) in neoadjuvant chemotherapy died before surgery, in other groups there weren’t any lethal outcomes (p = 0.283). Only the male sex, had a statistically significant effect on the anastomotic leak rate (risk ratio (HR) 2.875; 95 % confidence interval (CI) 1.24–6.63; p = 0.003).Conclusions. A study of these case histories of patients with cancer of the upper ampullary rectum, conducted by us, showed that neoadjuvant treatment didn»t affect the postoperative complications rate.
Aim: to assess the effectiveness of neo-CT in the FOLFOX6 regimen in patients with mid- and upper rectal cancer (RC)associated with poor prognosis. Patients and methods: fifty-two patients were included into study. All had neo-CT with subsequent surgical treat-ment between 2017 and 2021. Of them 94.2% had stage III and 5.8% had stage II. An extramural vascular invasionwas detected by MRI in 33 (63.5%) patients. The distance between the tumor and the mesorectal fascia was ≤ 2 mmin 17%. All patients had 4 cycles of neo-CT in FOLFOX6 regimen followed by surgery. Results: the compliance (≥ 4 cycles of neo-CT) was 82.7 % (n = 43). The overall toxicity rate was 35.6 %. Sphincter-saving surgery was performed in 51 (98.1 %) patients. Postoperative morbidity was 25.0 %. Final pathology revealed stage III in 29 (55.8 %) patients, stage 0 — stage II — in 22 (42.3 %). In accordance with the degree of pathomorphosis (CAP, 2019), 12 (23.1 %) patients showed a partial response. In one patient (1.9 %) no signs of residual tumor were detected. Downstaging of the T stage compared with MRI data before neo-CT was noted in 23 (44.2 %) patients, N stage — in 29 (55.8 %). With a mean follow-up of 31 (3-54) months, local recurrences were detected in 5 (9.6 %) patients, and distant metastases in 4 (7.7 %). The cumulative 3-year recurrence rate was 11.3 ± 4.8 %. The three-year overall and recurrence-free survival rate was 88.2 ± 5.8 % and 76.4 ± 7.4 %, respectively. Conclusion: the multimodal approach for RC with adverse prognostic factors using neo-CT in the FOLFOX6 regimenis well tolerated by patients, has a small toxicity and postoperative morbidity as well. It is necessary to develop newpathology criteria for tumor response to neo-CT.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.