title: Five-year outcomes of preoperative chemoradiation for rectal carcinoma in Saudi population: single-institutional experience.
abstract: OBJECTIVE
  Preoperative chemoradiation (CRT) followed by surgery is the standard treatment for locally advanced rectal cancer (LARC). The outcomes of preoperative CRT in Saudi patients with LARC have not been widely studied. The study reports long-term outcomes after preoperative CRT followed by curative surgery in Saudi patients with LARC.
  
  
  METHODS
  A retrospective, single-institutional study performed in the tertiary care oncology center in Saudi Arabia.
  
  
  METHODS
  A total of 154 out of 204 patients with LARC were treated with preoperative CRT and followed by surgery at the oncology center between September 2005 and November 2012. Data regarding the response rates, toxicity profile, locoregional control (LRC), distant metastasis control (DMC), overall survival (OS), and disease-free survival (DFS) rates were analyzed.
  
  
  RESULTS
  The median age of the study population was 56.6 years (range: 26-89). Predominant clinical stages were IIA (70 patients; 45.4%) and IIIB (49 patients; 31.8%). Majority of patients (79.8%) underwent a complete total mesorectal excision (TME). Complete pathological response (ypT0N0) was seen in 26 patients (16.8%). At 5 years, locoregional recurrence (LR) was reported in 12 patients (7.8%), and distant metastases were noted in 33 patients (21.4%). The 5-year cumulative LRC, DMC, OS, and DFS rates were 91%, 71.3%, 78%, and 64.8%, respectively. Stage, nodal status, circumferential margins, ypT0N0, and adjuvant chemotherapy were found to be important prognostic factors for DFS.
  
  
  CONCLUSIONS
  The results of preoperative CRT followed by surgery and adjuvant chemotherapy in Saudi population are comparable with international data.
authors.forename: Eyad Fawzi
authors.initials: EF
authors.lastname: AlSaeed
authors.affiliation: Mutahir Ali Tunio, MBBS, FCPS, Radiation Oncology,, Comprehensive Cancer Center,, King Fahad Medical City,, Riyadh 59046, Saudi Arabia, T: +966509001555, F: +96612889957, drmutahirtonio@hotmail.com.
authors.forename: Mutahir
authors.initials: M
authors.lastname: Tunio
authors.forename: Ahmad
authors.initials: A
authors.lastname: Zubaidi
authors.forename: Omar
authors.initials: O
authors.lastname: Al-Obaid
authors.forename: Abdullah Kamal
authors.initials: AK
authors.lastname: Ahmed
authors.forename: Omar Abdulmohsen
authors.initials: OA
authors.lastname: Al-Omar
authors.forename: Emad Ahmed
authors.initials: EA
authors.lastname: Abid
authors.forename: Mohammed Jaber
authors.initials: MJ
authors.lastname: Alsiwat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000401:mortality*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D012529:Saudi Arabia; D016896:Treatment Outcome