Treatment Of Rectal Cancer By Chemoradiation Followed By Surgery: Analysis And Early Clinical Outcome In 66 Patients

Background: Abdominoperineal resection entails the need for a permanent colostomy, which significantly reduces patient self-image and quality of life.Objective: To investigate the effectiveness of preoperative chemoradiation in increasing there sectability rates of rectal cancer and increasing the anal sphincter preservation rate.Methods: The study group included 66 patients aged 33-84 years with T-2-T-3 rectal carcinoma who were treated in our institute from 1997 to 2002 with preoperative chemoradiation followed by surgery 6 weeks later. All patients underwent preoperative transrectal endoscopic ultrasound for tumor staging and localization. The duration of follow-up was 25 months.Results: Chemoradiation led to tumor downstaging in 61 patients (92.4%), all of whom underwent low anterior resection. Only 11.4% of 1 this group needed a temporary (6=weeks) loop colostomy/ileostomy.; None of the 16 patients with post-treatment T-0 tumors had evidence of malignant cells on, pathologic study. Five patients (7.6%) failed F to respond to chemoradiation and underwent APR. There were no major complications; such as leakage, and no deaths.Conclusions: Neoadjuvant chemoradiation is an effective modality to downstage advanced rectal cancer, improving patient quality of life by significantly reducing the need for a terminal permanent colostomy, or even a temporary one.