Preoperative chemotherapy and radiation therapy for locally advanced primary and recurrent rectal carcinoma. A report of surgical morbidity

Background. Complete surgical resection of locally advanced primary and recurrent rectal cancer is often incomplete. Improved tumor downstaging may improve resection rates and local control if postoperative morbidity is not increased. Methods. The clinical and pathologic records of 119 patients with...

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Bibliographic Details
Published in:Cancer 1993-06, Vol.71 (11), p.3690-3696
Main Authors: Shumate, Charles R., Ota, David M., Skibber, John M., Rich, Tyvin A., Ajani, Jaffer A.
Format: Article
Language:English
Subjects:
Antineoplastic agents
Antineoplastic Combined Chemotherapy Protocols
Biological and medical sciences
chemotherapy
Chemotherapy, Adjuvant
Cisplatin - administration & dosage
Combined Modality Therapy
Combined treatments (chemotherapy of immunotherapy associated with an other treatment)
Female
Fluorouracil - administration & dosage
Humans
locally advanced
Male
Medical sciences
Middle Aged
morbidity
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - radiotherapy
Neoplasm Recurrence, Local - surgery
Neoplasm Staging
Pharmacology. Drug treatments
Preoperative Care
radiation
Radiotherapy Dosage
rectal carcinoma
Rectal Neoplasms - drug therapy
Rectal Neoplasms - pathology
Rectal Neoplasms - radiotherapy
Rectal Neoplasms - surgery
recurrent
surgery
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Summary:Background. Complete surgical resection of locally advanced primary and recurrent rectal cancer is often incomplete. Improved tumor downstaging may improve resection rates and local control if postoperative morbidity is not increased. Methods. The clinical and pathologic records of 119 patients with locally advanced primary and recurrent rectal carcinoma were reviewed to determine the effect of preoperative chemoradiation on postoperative morbidity compared with a control group treated with external beam radiation therapy alone. Group I (56 patients) was treated with 45 Gy of external beam radiation therapy. Group II (63 patients) received 45 Gy of external beam radiation therapy with continuous‐infusion cisplatin, 5‐fluorouracil, or both. Results. Forty‐one patients (73.2%) in Group I and 48 in Group II (76.1%) underwent surgical resection. Anal‐sparing procedures were performed more frequently in Group II (25%) than in Group I (5.3%, P < 0.05). The overall complication rate for Group I was 51% versus 44% for Group II (P < 0.05) or 1.17 complications per patient in Group I and 0.58 complications per patient in Group II. One patient in each group died of treatment‐related septic complications. Conclusions. It was concluded that the addition of chemotherapy to radiation to treat rectal carcinoma does not result in an increased operative morbidity and may contribute to a higher proportion of patients being treated with anal–rectal‐conserving surgical procedures.
ISSN:0008-543X
1097-0142
DOI:10.1002/1097-0142(19930601)71:11<3690::AID-CNCR2820711136>3.0.CO;2-H