The surgical outcome of preoperative chemoradiation therapy for ultra low rectal cancer.
OBJECTIVE
To evaluate the surgical outcome of preoperative long-course chemoradiation therapy (PCRT) in patients with ultra low rectal cancer.


METHODS
Medical records of patients with rectal adenocarcinoma located within the length of 5 cm from the anal verge, who underwent elective oncological resection between 2003 and 2006 at Siriraj Hospital, were reviewed. PCRT was performed in some patients based on tumor characteristics and surgeon's decision. Rate of sphincter preservation and other surgical outcomes were assessed.


RESULTS
Ninety-three patients with an average age of 60 years were studied. Twenty-seven (29%) received PCRT. There was no difference in demographic data and location of the tumor between PCRT and non-PCRT group. Patients with PCRT had a smaller size of tumor (2.6 vs. 5.0 cm, p < 0.001) and better tumor staging (p < 0.001). Complete pathological response was found in four patients with PCRT (15%). However, there was no significant difference in SPP rate between PCRT and non-PCRT group (37% vs. 36%, p = 0.95). Other surgical outcomes between the two groups were also not different.


CONCLUSIONS
PCRT did not increase rate of sphincter preservation in patients with low rectal cancer.
Boonnuch
Wiroon
W
Colorectal Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Lohsiriwat
Varut
V
Akaraviputh
Thawatchai
T
Chinswangwatanakul
Vitoon
V
Lohsiriwat
Darin
D
D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome