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Titolo:
Neoadjuvant chemoradiation for rectal cancer: Analysis of clinical outcomes from a 13-year institutional experience
Autore:
Onaitis, MW; Noone, RB; Hartwig, M; Hurwitz, H; Morse, M; Jowell, P; McGrath, K; Lee, C; Anscher, MS; Clary, B; Mantyh, C; Pappas, TN; Ludwig, K; Seigler, HF; Tyler, DS;
Indirizzi:
Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA Duke Univ Durham NC USA 27710 v, Med Ctr, Dept Surg, Durham, NC 27710 USA Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA Duke Univ Durham NC USA 27710 iv, Med Ctr, Dept Med, Durham, NC 27710 USA Duke Univ, Med Ctr, Dept Radiat Oncol, Durham, NC 27710 USA Duke Univ Durham NC USA 27710 tr, Dept Radiat Oncol, Durham, NC 27710 USA
Titolo Testata:
ANNALS OF SURGERY
fascicolo: 6, volume: 233, anno: 2001,
pagine: 778 - 785
SICI:
0003-4932(200106)233:6<778:NCFRCA>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
PREOPERATIVE RADIATION-THERAPY; TOTAL MESORECTAL EXCISION; PROGNOSTIC IMPLICATIONS; SPHINCTER PRESERVATION; RANDOMIZED TRIAL; ADJUVANT THERAPY; RADIOTHERAPY; CARCINOMA; CHEMOTHERAPY; RESECTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Tyler, DS Duke Univ, Med Ctr, Dept Surg, DUMC Box 3118, Durham, NC 27710 USA Duke Univ DUMC Box 3118 Durham NC USA 27710 Durham, NC 27710 USA
Citazione:
M.W. Onaitis et al., "Neoadjuvant chemoradiation for rectal cancer: Analysis of clinical outcomes from a 13-year institutional experience", ANN SURG, 233(6), 2001, pp. 778-785

Abstract

ObjectiveTo examine clinical outcomes in patients receiving neoadjuvant chemoradiation for locally advanced rectal adenocarcinoma. Summary Background DataPreoperative radiation therapy, either alone or in combination with 5-fluorouracil-based chemotherapy, has proven both safe and effective in the treatment of rectal cancer. However, data are lacking regarding which subgroupsof patients benefit from the therapy in terms of decreased local recurrence and increased survival rates. MethodsA retrospective chart review was performed on 141 consecutive patients whoreceived neoadjuvant chemoradiation (5-fluorouracil +/- cisplatin and 4,500-5,040 cGy) for biopsy-proven locally advanced adenocarcinoma of the rectum. Surgery was performed 4 to 8 weeks after completion of chemoradiation. Standard statistical methods were used to analyze recurrence and survival. ResultsMedian follow-up was 27 months, and mean age was 59 years (range 28-81). Mean tumor distance from the anal verge was 6 cm (range 1-15). Of those staged before surgery with endorectal ultrasound or magnetic resonance imaging,57% of stage II patients and 82% of stage III patients were downstaged. The chemotherapeutic regimens were well tolerated, and resections were performed on 140 patients. The percentage of sphincter-sparing procedures increased from 20% before 1996 to 76% after 1996. On pathologic analysis, 24% of specimens were T0. However, postoperative pathologic T stage had no effect on either recurrence or survival. Positive lymph node status predicted increased local recurrence and decreased survival. ConclusionsNeoadjuvant chemoradiation is safe. effective, and well tolerated. Postoperative lymph node status is the only independent predictor of recurrence and survival.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 12:00:54