Surgical approach and sandwich radiotherapy for resectable rectal cancer: advantages and problems.
One hundred and twelve patients with locally advanced adenocarcinoma of the rectum have been treated with a protocol of adjuvant radiotherapy from 1981 to 1989. Radiotherapy was administered with a "sandwich" method at a dosage of 2700 cGy preoperatively and of 1800 cGy post-operatively. Only patients in stages B and C have been considered for results. Postoperative morbidity has been 16% and postoperative mortality 2.7%. Local failure was seen in 20% of patients without significant differences by stage, location, grading and operative technique. Distant metastases were seen in 31% of patients. Five-year actuarial survival was 49% and respectively 58% in stage B and 38% in stage C (P less than 0.01). Compared with a series of historical controls treated with surgery alone, the local recurrence rate was 20% vs. 26%, the distant metastases rate was 31% vs. 38% and the five-year actuarial survival rate was 49% vs. 36% (P greater than 0.01).
Picciocchi
A
A
Department of General Surgery (Semeiotica Chirurgica), Università Cattolica del Sacro Cuore, Rome, Italy.
Magistrelli
P
P
Coco
C
C
Masetti
R
R
Roncolini
G
G
Perrotti
P
P
Cellini
N
N
Valentini
V
V
D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000379:methods*; D012004:Rectal Neoplasms / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate