title: Patterns of Local Recurrence and Oncologic Outcomes in T3 Low Rectal Cancer (≤5 cm from the Anal Verge) Treated With Short-Course Radiotherapy With Delayed Surgery : Outcomes in T3 Low Rectal Cancer Treated With Short-Course Radiotherapy With Delayed Surgery.
abstract: BACKGROUND
  Short-course radiotherapy with delayed surgery (SRT-delay) is still under clinical investigation for its efficacy in treating low rectal cancer (≤5 cm from the anal verge). This study was designed to assess the pattern of local recurrence and oncologic outcomes in T3 low rectal cancer treated with SRT-delay.
  
  
  METHODS
  This study enrolled T3 low rectal cancer patients without distant metastasis between 2003 and 2015. All patients received total mesorectal excision following SRT-delay (25 Gy/10 fractions/5 days + S-1 radiosensitizer with a 4-week delay of surgery). The median follow-up period was 69 (range 1-149) months.
  
  
  RESULTS
  A total 119 consecutive patients had low rectal cancer; 104 (87.4 %) underwent intersphincteric resection (ISR), and 15 (12.6 %) underwent abdominoperineal resection (APR). Fifty-six patients (47.1 %) were ypT-downstaged, 86 (72.2 %) were ypN0, and 10 (8.4 %) had circumferential resection margin involvement. The 5-year local recurrence-free survival, recurrence-free survival, and overall survival were 93.0, 76.2, and 80.5 %, respectively. Nine patients experienced local recurrence: lateral pelvic recurrence in six patients (5.0 %) and central pelvic recurrence in three (2.5 %).
  
  
  CONCLUSIONS
  A total of 87.4 % of sphincter-preserving surgeries were performed for T3 low rectal cancer following SRT-delay. Pathological tumor downstaging, circumferential resection margin involvement, local recurrence, and oncologic outcomes were acceptable; therefore, the SRT-delay regimen may be an option for treating T3 low rectal cancer.
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan. n_beppu@yahoo.co.jp.
authors.forename: Naohito
authors.initials: N
authors.lastname: Beppu
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Aihara
authors.affiliation: Department of Radiology, Meiwa Hospital, Nishinomiya, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Doi
authors.affiliation: Department of Surgrey, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yanagi
authors.affiliation: Department of Surgery, Meiwa Hospital, Nishinomiya, Hyogo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome