title: Neoadjuvant chemotherapy rather than neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer with high tumor burden.
abstract: OBJECTIVE
  We investigated the characteristics of locally advanced rectal cancer (LARC) patients who had received neoadjuvant chemoradiotherapy (NCRT), and who developed early metastasis during the perioperative period.
  
  
  METHODS
  LARC who were treated and followed-up were included in this study. Patients' files were reviewed retrospectively and the data on patients were recorded.
  
  
  RESULTS
  Totally, 182 stage II and III rectal cancer patients who received NCRT were retrospectively evaluated. Seventeen (9.3%) patients were metastatic during the perioperative period. Of them, metastases developed preoperatively in 3 (17.6%) patients after NCRT, while 14 (82.4%) developed metastases postoperatively before adjuvant chemotherapy (CT). Twelve (70.6%) patients had clinical stage T4N+ disease. The median time interval between pathological diagnosis and metastasis development was 4 (3-5) months. The median survival was 24 months.
  
  
  CONCLUSIONS
  More effective treatment is warranted in patients with LARC with a high tumor burden.
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Dokuz Eyliil University, Medical Faculty, Izmir, Turkey. dogankoca@hotmail.com
authors.forename: Dogan
authors.initials: D
authors.lastname: Koca
authors.forename: Jlhan
authors.initials: J
authors.lastname: Oztop
authors.forename: Ugur
authors.initials: U
authors.lastname: Yilmaz
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000556:secondary / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000556:secondary / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult