Abstract:Background: The aim of this study was to identify subgroups that benefit from preoperative or postoperative chemoradiotherapy (CRT) for rectal cancer of intermediate stage. Patients and Methods: Between 1999 and 2004, 118 and 177 patients matched with respect to clinical T stage, circumferential tumor extent (= 60% / > 60%), lymph node metastasis, and lymph node size (< 1 cm / = 1 cm), were allocated to preoperative CRT and postoperative CRT, respectively. In preoperative CRT, a total of 45 Gy was delivered wi… Show more
“…In our study, unlike others, we focused on circumferential extent of the tumour, which should be well measured by preoperative imaging techniques (i.e. MRI) and more accurately reflects the extent of the tumour [5,[11][12][13][14].…”
The study demonstrated that, even for small tumours involving only one rectal quadrant, the risk of lymph nodal involvement was about 25%. Had the patients undergone local excision the treatment would have been incomplete.
“…In our study, unlike others, we focused on circumferential extent of the tumour, which should be well measured by preoperative imaging techniques (i.e. MRI) and more accurately reflects the extent of the tumour [5,[11][12][13][14].…”
The study demonstrated that, even for small tumours involving only one rectal quadrant, the risk of lymph nodal involvement was about 25%. Had the patients undergone local excision the treatment would have been incomplete.
“…Won Sup Yoon and colleagues [21] performed a retrospective matched pair analysis on patients treated with preoperative or postoperative radiochemotherapy in locally advancedrectalcancerwiththeaimtoidentifythefeaturesof thesubgroupsofpatientswhichhadmorebenefitfromaneoadjuvant approach. The manuscript unfortunately failed in this aim, because study design and methodological aspects didn'tsupporttheirconclusion.However,theaimofidentifyingsubgroupfeaturesfortailoringtreatmentsisrelevantand furthereffortsareneededtolookforreliableevidencebefore movingawayfromconsolidateknowledge.…”
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