Clinical outcomes of local excision following preoperative chemoradiotherapy for locally advanced rectal cancer.
OBJECTIVE
To evaluate the treatment outcomes of local excision following preoperative chemoradiotherapy in patients with locally advanced rectal cancer who have not undergone radical surgery for any reason.


METHODS
The data of 27 patients with locally advanced rectal cancer who underwent preoperative chemoradiotherapy followed by local excision were analyzed retrospectively. The primary endpoint was the 5-year relapse-free survival rate, and the secondary endpoint was the pattern of recurrence.


RESULTS
The median follow-up time was 81.8 months (range, 28.6 to 138.5 months). The 5-year local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were 88.9%, 81.1%, 77.8%, and 85.0%, respectively. Six (22%) patients developed treatment failure; one (4%) patient had local recurrence only, three (11%) patients had distant recurrence only, and two (7%) patients had both. The 5-year LRFS, DMFS, RFS, and OS for patients with ypT0-1 compared with ypT2-3 were 94.1% vs. 77.8% (p=0.244), 94.1% vs. 55.6% (p=0.016), 88.2% vs. 55.6% (p=0.051), and 94.1% vs. 66.7% (p=0.073), respectively.


CONCLUSIONS
Local excision following preoperative chemoradiotherapy may be an alternative treatment for highly selected patients with locally advanced rectal cancer who have achieved ypT0-1 after preoperative chemoradiotherapy.
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea. ; Department Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Nam Kwon
NK
Lee
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea. ; Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Dae Yong
DY
Kim
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Sun Young
SY
Kim
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Jae Hwan
JH
Oh
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Won
W
Park
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Doo Ho
DH
Choi
Department of Radiation Oncology, Chonnam National University Ewha Womans University Mokdong Hospital, Gwangju, Korea.
Taek-Keun
TK
Nam
Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Kyung-Ja
KJ
Lee
Local excision; Preoperative chemoradiotherapy; Rectal neoplasms; Survival