Combined-modality therapy with sphincter-preserving total mesorectal excision for locally advanced rectal cancer: patient's age and long-term outcome.

摘要: BACKGROUND In rectal cancer patients anterior resection with total mesorectal excision (TME) results in good functional outcomes, optimal local control and improved survival. However, locally advanced tumours still have a high risk of oncological relapse may benefit from neo- or adjuvant therapy. AIM. The purpose this study was to identify the clinico-pathological features related poor prognosis after sphincter-saving curative combined-modality therapy for cancer. MATERIAL AND METHOD Forty-eight consecutive UICC stage II III carcinoma operated on TME were studied prospectively. Fifteen received neoadjuvant radiotherapy postoperative chemotherapy; remainder combined chemoradiotherapy given. RESULTS Five-year cancer-specific survival rate 49%. Patient's gender, tumour location, grade, mucinous histology, direct spread, type growth margin lymphocytic infiltration revealed be factors without statistical importance. Only positive nodal status (31.6 +/- 11.0 vs 61.5 9.7) patient's age (38.5 9.7 63.2 11.4) significantly decreased (p=0.038 0.048, respectively). multivariate analysis both parameters independently influenced (p=0.045 0.038; Relative Risk 2.26 2.13; Odds Ratio 4.21 1.07, CONCLUSIONS An elderly seems an independent prognostic factor associated treatment even when non-cancer causes death are excluded. Thus, older should integral part careful benefit-toxicity analysis.