Sphincter preservation in distal CT2N0 rectal cancer after preoperative chemoradiotherapy

Nir Wasserberg, Yulia Kundel, Ofer Purim, Andrei Keidar, Hanoch Kashtan, Eran Sadot, Eyal Fenig, Baruch Brenner

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4 Scopus citations

Abstract

BACKGROUND: Preoperative chemoradiotherapy is usually not indicated for cT2N0 rectal cancer. Abdominoperineal resection is the standard treatment for distal rectal tumors. The aim of the study was to evaluate the actual sphincter-preservation rate in patients with distal cT2N0 rectal cancer given neoadjuvant chemoradiotherapy.

METHODS: Data were retrospectively collected for all patients who were diagnosed with distal cT2N0 rectal cancer at a tertiary medical center in 2000-2008 and received chemoradiotherapy followed by surgery (5-7 weeks later).

RESULTS: Thirty-three patients (22 male) of median age 65 years (range, 32-88) were identified. Tumor distance from the anal verge ranged from 0 to 5 cm. R0 resection with sphincter preservation was accomplished in 22 patients (66%), with a 22% pathological complete response rate. Median follow-up time was 62 months (range 7-120). There were no local failures. Crude disease-free and overall survival were 82% and 86%, respectively. Factors associated with sphincter preservation were tumor location (OR=0.58, p=0.02, 95% CI=0.37-0.91) and pathological downstaging (OR=7.8, p=0.02, 95% CI=1.35-45.85). Chemoradiotherapy was well tolerated.

CONCLUSION: High rates of sphincter preservation can be achieved after preoperative chemoradiotherapy for distal cT2N0 rectal cancer, with tolerable toxicity, without compromising oncological outcome.

Original languageEnglish
Article number233
Pages (from-to)233
Number of pages1
JournalRadiation Oncology
Volume9
DOIs
StatePublished - 22 Oct 2014
Externally publishedYes

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