title: Preoperative chemoradiation for rectal cancer: results of multimodality management and analysis of prognostic factors.
abstract: BACKGROUND
  Our goals were to examine the impact of neoadjuvant chemoradiation for rectal cancer on surgical outcomes and to determine prognostic factors predicting improved survival.
  
  
  METHODS
  Retrospective cohort of 56 male and 44 female patients.
  
  
  RESULTS
  After preoperative chemoradiation, 73% of patients had sphincter-preserving surgery. The 5-year disease-free (DFS) and overall survival rates were 77% and 81%, respectively. Twenty-five percent of patients showed a complete pathologic response. T-level downstaging and pathologic T stage did not correlate with recurrence or survival rates. Pathologic nodal stage was associated with a significant difference in recurrence rates (N(0) 19%, N1 20%, and N2 75%, P = .038) and DFS (N0/N1 vs. N2, 79% vs. 25%, P = .002).
  
  
  CONCLUSIONS
  Neoadjuvant chemoradiation resulted in a high rate of sphincter preservation. Complete pathologic responses after surgery were frequent and although pathologic T stage after surgery did not affect recurrence rates, pathologic nodal response was associated with improved recurrence and survival rates.
authors.affiliation: Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Anand T
authors.initials: AT
authors.lastname: Shivnani
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Stryker
authors.forename: Krystyna D
authors.initials: KD
authors.lastname: Kiel
authors.forename: Sherry
authors.initials: S
authors.lastname: Lim
authors.forename: Amy L
authors.initials: AL
authors.lastname: Halverson
authors.forename: Mark S
authors.initials: MS
authors.lastname: Talamonti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods / Q000706:statistics & numerical data; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome