title: Usefulness of frozen-section examination in resected mid-rectal cancer after preoperative radiation.
abstract: The surgical treatment of rectal cancer of the middle third remains controversial. We treated 30 consecutive patients with preoperative radiotherapy (45 Gy) and low anterior resection. Anastomoses were performed with a stapler. Intraoperative frozen-section examination of the rectal margin established that it was free of tumor. Two patients died of surgery-related causes. Median follow-up of the remaining patients is now 52 months (range: 26 to 76 months). Eight patients had recurrences documented at surgical re-exploration: two local (pelvic) only, three local and distant, and two distant only. Local recurrences happened despite a frozen-section examination of the rectal margin negative for tumor. Six of the eight patients who experienced a recurrence have died of disease progression. Distant metastases were found in six other patients during follow-up; they subsequently died. Thus, our therapeutic approach was not associated with decreases in local or overall recurrences.
authors.affiliation: Division of Surgical Oncology and Radiotherapy, Centro Medico Nacional, D.F.
authors.forename: P
authors.initials: P
authors.lastname: Luna-Perez
authors.forename: H
authors.initials: H
authors.lastname: Barrientos
authors.forename: S
authors.initials: S
authors.lastname: Delgado
authors.forename: A
authors.initials: A
authors.lastname: Morales
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D006801:Humans; D008297:Male; D008867:Microtomy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012007:Rectum / Q000473:pathology; D013997:Time Factors