title: B1 versus B2 Dukes stage rectal cancer: prospective evaluation of 87 patients in a single institution and quest for re-evaluation of the current protocol.
abstract: OBJECTIVE
  Current protocols indicate surgery as single modality of therapy for B1 stage rectal cancer and surgery with adjuvant therapy for B2 stage. The aim of our study was to analyze the five-year survival rate for patients with surgically treated B1 and B2 rectal cancer and to assess the impact of adjuvant therapy on overall survival.
  
  
  METHODS
  Our epidemiological clinical study was based on a prospective analysis of 87 cases of B1 (n=32) and B2 (n=55) rectal cancers operated between 2000 and 2003. Survival evaluation was done through a prospective cohort followup study.
  
  
  RESULTS
  There were 33 female and 54 males with a median age of 60 years (IQR 39-74). Tumor location was low rectum for 23 patients (26.4%), medium rectum for 30 patients (34.5%) and high rectum at 34 patients (37.9%). We performed Miles operation in 42 cases, Dixon resection in 26 cases and Hartmann operation in 18 patients. There was no difference in the number and type of postoperative complications between groups. There were no local recurrences in the B1 stage group but 7 cases (12.7%) in the B2 stage group. Distant metastases were recorded in 8 patients (25%) in the B1 group and 2 patients (3.6%) in the B2 group. The survival rate at 5 years (S5) was better for the B2 stage S5=69.9% than B1 stage S5=53.5% (p=0.001).
  
  
  CONCLUSIONS
  Patients with B1 stage rectal cancer might benefit from adjuvant/neoadjuvant therapy.
authors.affiliation: Second Department of Surgery, University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Costea
authors.forename: Narcis Octavian
authors.initials: NO
authors.lastname: Zarnescu
authors.forename: Eugenia Claudia
authors.initials: EC
authors.lastname: Vasiliu
authors.forename: Dana
authors.initials: D
authors.lastname: Minca
authors.forename: Maria
authors.initials: M
authors.lastname: Sajin
authors.forename: Stefan
authors.initials: S
authors.lastname: Neagu
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D012383:Romania; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome