Clinical outcome in patients with complete pathologic response (pT0) to preoperative irradiation/chemo-irradiation operated for locally advanced or locally recurrent rectal cancer

Background The importance of pT0 stage after preoperative radiation/chemoradiation is unclear. Methods Four hundred and nineteen patients had preoperative irradiation (46–50 Gy/2 Gy fractions) for primary locally advanced (PLA) or locally recurrent (LR) rectal cancer. 141 PLA and 65 LR cases with R0...

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Bibliographic Details
Published in:Journal of surgical oncology 2005-10, Vol.92 (1), p.70-75
Main Authors: Wiig, Johan N., Larsen, Stein G., Dueland, Svein, Giercksky, Karl-Erik
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Adenocarcinoma - pathology
Adenocarcinoma - radiotherapy
Adult
advanced rectal cancer
Aged
Combined Modality Therapy
Female
Humans
local recurrence
Male
Middle Aged
Neoplasm Recurrence, Local
Preoperative Care
preoperative chemoradiation
Rectal Neoplasms - drug therapy
Rectal Neoplasms - pathology
Rectal Neoplasms - radiotherapy
Rectal Neoplasms - surgery
survival
Survival Analysis
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Summary:Background The importance of pT0 stage after preoperative radiation/chemoradiation is unclear. Methods Four hundred and nineteen patients had preoperative irradiation (46–50 Gy/2 Gy fractions) for primary locally advanced (PLA) or locally recurrent (LR) rectal cancer. 141 PLA and 65 LR cases with R0 resections/M0 stage are studied. Two of the pT0 PLA patients had also been given sensitizing chemotherapy and two pT0 in the LR group had received pelvic hyperthermia as well. Results pT0 was achieved in 7% of 229 PLA and 8% of 190 LR patients. For the PLA group, actuarial 5‐year survival of pT0 was 90% versus 53% for the pT > 0 group. The difference was statistically significant. At five years local recurrence was zero in pT0 patients versus 23% in pT > 0 (not significant). For the LR groups 5‐year‐survival was 62% for pT0 versus 45% for the other pT‐stages, local recurrence was 17 and 35% respectively (not significant). The seemingly better results for pT0 cases of PLA cancers versus the LR ones did not reach statistical significance. Conclusion pT0 after preoperative irradiation is associated with improved survival for pT0 cases of PLA. Our studies on pT0 LR was suggestive of an improvement in this group as well. J. Surg. Oncol. 2005;92:70–75. © 2005 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.20340