Analysis of anal sphincter preservation rate according to tumor level and neoadjuvant chemoradiotherapy in rectal cancer patients.
The anal sphincter preservation rate (ASPR) according to tumor level and neoadjuvant chemoradiotherpy (CRT) has not been fully evaluated. Therefore, the aim of this study was to evaluate the correlation between the tumor level, neoadjuvant CRT, and the ASPR in rectal cancer patients. We studied 544 patients (tumor level, 0-6 cm) who underwent curative resection for rectal cancer between 1991 and 2005. Patients were divided six into groups according to tumor level over 1-cm intervals, and the ASPR was evaluated in patients with and without neoadjuvant CRT according to tumor level. Sphincter preservation surgery was performed in 191 patients, and 86 patents underwent neoadjuvant CRT. The overall ASPR was 43.0% (37/86) in patients with neoadjuvant CRT and 33.6% (154/458) in patients without neoadjuvant CRT (P=0.094). In an analysis according to tumor level, the ASPR was 0.0 vs 0.0% in <or=1 cm, 0.0 vs 2.1% in 1<or=2 cm (P=0.589), 11.8 vs 16.8% in 2<or=3 cm (P=0.599), 55.6 vs 20.2% in 3<or=4 cm (P=0.001), 57.7 vs 45.9% in 4<or=5 cm (P=0.227), and 66.7 vs 69.5% in 5<or=6 cm (P=0.827). Neoadjuvant CRT did not increase the ASPR in tumor level within <or=6 cm. However, for the tumor level (3<or=4 cm), neoadjuvant CRT significantly increased the ASPR.
Baik
Seung Hyuk
SH
Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, C.P.O. Box 8044, 120-752, Seoul, South Korea.
Kim
Nam Kyu
NK
Lee
Kang Young
KY
Sohn
Seung Kook
SK
Cho
Chang Hwan
CH
D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D001003:Anal Canal / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003082:Colectomy / Q000379:methods*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D002955:Leucovorin; D005472:Fluorouracil
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