Neoadjuvant radiochemotherapy and surgery for advanced rectal cancer

摘要: Preoperative radiochemotherapy is widely used in the treatment of locally advanced rectal cancer. The predictive value of response to neoadjuvant remains uncertain. We retrospectively evaluated impact downstaging and tumor regression as prognostic factors its influence on ability perform sphincter-sparing surgery. A total 72 consecutive patients with cancer were included this retrospective analysis. All treated preoperative 5-fluorouracil-based chemotherapy pelvic radiation a dose 50.4 Gy followed by surgery 6 weeks later. sphincter-preserving procedure could be performed 42 patients, all complete resection (R0) was achieved. pathological (ypT0, ypN0) was achieved 8 (11%) patients. None showing a complete relapsed or died during follow-up period. At median 28 months, 65 patients were alive, none these had local recurrence 15 metastatic disease. Patients complete pathological significantly better 2-year disease-free survival compared ≥10% residual tumor cells (p = 0.024). years age (p 0.036). Acute toxicity moderate. an effective safe for cancer. Pathological parameters after radiochemotherapy, including regression grading, correlated with disease-free survival. grading needs further validated prospective clinical trials.