[Rectal cancer. The effect of the clinical stage and the degree of lymphatic invasion on local recurrence and survival. An analysis of 168 patients].
BACKGROUND
Surgery is the most important therapeutic means for treatment of rectal carcinoma. Nevertheless, from stage B2, relapse rates are high and it is therefore necessary to use supplemental treatments such as radiotherapy associated or not with chemotherapy


OBJECTIVE
To assess the likelihood of being free of local, local and distant disease and overall and specific survival in function of clinical stage and degree of lymph node involvement among patients diagnosed with colo-rectal adenocarcinoma treated with radical surgery and radiotherapy associated or not with chemotherapy.


METHODS
Since January 1990 up to December 1997, all patients with rectal adenocarcinoma treated with radical surgery and postoperative radiotherapy, with or without chemotherapy, were prospectively included in a database which was analyzed.


RESULTS
The crude actuarial survival at five years was 61.1 +/- 9.2% and specific survival 64.2 +/- 9.2%. As for stages: B (84.1 +/- 10.1%) and C (49.9 +/- 3.3%) (p < 0.001). Likewise, for N0 84.1 +/- 10.1%, for N1 62.2 +/- 13.5% and for N2 13.7 +/- 22.3% (p < 0.001). The likelihood of being in complete remission for the overall patient population was 50.2 +/- 9.2%: B (67.5 +/- 13.5%) and C (37.9 +/- 11.9%) (p < 0.001). Likewise, for N0 67.5 +/- 13.5%, for N1 47.8 +/- 13.5%, and for N2 9.9 +/- 17% (p < 0.001).


CONCLUSIONS
Given the poor results obtained in stages C, particularly stage N2 and also that a better local control is obtained with good tolerance when preoperative radiotherapy is administered, we believe that in order to improve the results it is necessary to initiate preoperative radiotherapy.
Reig Castillejo
A
A
Servicio de Oncología Radioterápica, Hospital de la Esperanza, Barcelona.
Algara López
M
M
Foro Arnalot
P
P
Lacruz Bassols
M
M
Sanz Latiesas
X
X
Ferrer González
F
F
Valls Fontanals
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011182:Postoperative Care; D012004:Rectal Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000628:therapy