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Article: Outcome of anterior resection for stage II rectal cancer without radiation: The role of adjuvant chemotherapy

TitleOutcome of anterior resection for stage II rectal cancer without radiation: The role of adjuvant chemotherapy
Authors
KeywordsChemotherapy
Mesorectal excision
Radiation therapy
Rectal cancer
Issue Date2005
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/
Citation
Diseases Of The Colon And Rectum, 2005, v. 48 n. 2, p. 218-226 How to Cite?
AbstractBACKGROUND: This study aimed to evaluate the oncological outcome of patients who had Stage II rectal cancer and underwent curative nonsphincter-ablation surgery without adjuvant radiation. PATIENTS AND METHODS: During the study period from August 1993 to December 2002, 224 patients (141 men) with Stage II cancer underwent curative anterior resection or Hartmann's procedure without adjuvant radiation. Data were collected prospectively. The oncologic outcomes of these patients were studied and the risk factors for recurrence and survival were analyzed. RESULTS: The median age of the patients was 69 (range, 27-89) years and the median level of the tumor from the anal verge was 8 (range, 3-20) cm. Four patients (1.8 percent) died in the postoperative period and postoperative complications occurred in 74 patients (33 percent). The median follow-up time of the surviving patients was 43.6 months. The actuarial five-year recurrence rate was 25.4 percent, whereas the five-year actuarial local and systemic recurrence rates were 6.1 percent and 20 percent, respectively. On multivariate analysis, independent factors associated with a higher recurrence rate included lymphovascular invasion, perineural invasion, and absence of chemotherapy. The overall and cancer-specific survival rates of the patients were 71.1 percent and 81.1 percent, respectively. On multivariate analysis, only adjuvant chemotherapy (P = 0.024; hazard ratio = 6.04; 95 percent confidence interval, 1.27-28.74) and the absence of lymphovascular invasion (P = 0.002; hazard ratio = 3.77; 95 percent confidence interval, 1.63-8.77) were independent factors associated with significantly better cancer-specific survival. CONCLUSION: A low local recurrence rate can be achieved in patients with Stage II rectal cancer treated with nonsphincter-ablation surgery without adjuvant radiation. Postoperative chemotherapy is associated with a lower recurrence rate and higher survival rates. Further study is warranted to define the role of adjuvant chemotherapy in patients with rectal cancer. © The American Society of Colon and Rectal Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/83561
ISSN
2015 Impact Factor: 3.739
2015 SCImago Journal Rankings: 2.077
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorHo, JWCen_HK
dc.contributor.authorChan, Ren_HK
dc.contributor.authorAu, Gen_HK
dc.contributor.authorChu, KWen_HK
dc.date.accessioned2010-09-06T08:42:30Z-
dc.date.available2010-09-06T08:42:30Z-
dc.date.issued2005en_HK
dc.identifier.citationDiseases Of The Colon And Rectum, 2005, v. 48 n. 2, p. 218-226en_HK
dc.identifier.issn0012-3706en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83561-
dc.description.abstractBACKGROUND: This study aimed to evaluate the oncological outcome of patients who had Stage II rectal cancer and underwent curative nonsphincter-ablation surgery without adjuvant radiation. PATIENTS AND METHODS: During the study period from August 1993 to December 2002, 224 patients (141 men) with Stage II cancer underwent curative anterior resection or Hartmann's procedure without adjuvant radiation. Data were collected prospectively. The oncologic outcomes of these patients were studied and the risk factors for recurrence and survival were analyzed. RESULTS: The median age of the patients was 69 (range, 27-89) years and the median level of the tumor from the anal verge was 8 (range, 3-20) cm. Four patients (1.8 percent) died in the postoperative period and postoperative complications occurred in 74 patients (33 percent). The median follow-up time of the surviving patients was 43.6 months. The actuarial five-year recurrence rate was 25.4 percent, whereas the five-year actuarial local and systemic recurrence rates were 6.1 percent and 20 percent, respectively. On multivariate analysis, independent factors associated with a higher recurrence rate included lymphovascular invasion, perineural invasion, and absence of chemotherapy. The overall and cancer-specific survival rates of the patients were 71.1 percent and 81.1 percent, respectively. On multivariate analysis, only adjuvant chemotherapy (<ITALIC>P</ITALIC> = 0.024; hazard ratio = 6.04; 95 percent confidence interval, 1.27-28.74) and the absence of lymphovascular invasion (P = 0.002; hazard ratio = 3.77; 95 percent confidence interval, 1.63-8.77) were independent factors associated with significantly better cancer-specific survival. CONCLUSION: A low local recurrence rate can be achieved in patients with Stage II rectal cancer treated with nonsphincter-ablation surgery without adjuvant radiation. Postoperative chemotherapy is associated with a lower recurrence rate and higher survival rates. Further study is warranted to define the role of adjuvant chemotherapy in patients with rectal cancer. © The American Society of Colon and Rectal Surgeons.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/en_HK
dc.relation.ispartofDiseases of the Colon and Rectumen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectChemotherapyen_HK
dc.subjectMesorectal excisionen_HK
dc.subjectRadiation therapyen_HK
dc.subjectRectal canceren_HK
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshColorectal Surgery - methods-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshRectal Neoplasms - drug therapy - pathology - surgery-
dc.titleOutcome of anterior resection for stage II rectal cancer without radiation: The role of adjuvant chemotherapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-3706&volume=48&issue=2&spage=218&epage=226&date=2005&atitle=Outcome+of+anterior+resection+for+stage+II+rectal+cancer+without+radiation:+the+role+of+adjuvant+chemotherapyen_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s10350-004-0813-7en_HK
dc.identifier.pmid15711860-
dc.identifier.scopuseid_2-s2.0-17744363653en_HK
dc.identifier.hkuros99163en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-17744363653&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume48en_HK
dc.identifier.issue2en_HK
dc.identifier.spage218en_HK
dc.identifier.epage226en_HK
dc.identifier.isiWOS:000227423300007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridHo, JWC=7402649983en_HK
dc.identifier.scopusauthoridChan, R=8663654400en_HK
dc.identifier.scopusauthoridAu, G=7003748615en_HK
dc.identifier.scopusauthoridChu, KW=7402453653en_HK

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