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Dig Liver Dis. 2016 Nov;48(11):1372-1377. doi: 10.1016/j.dld.2016.05.012. Epub 2016 May 20.

Non-surgical management of rectal cancer. Series of 68 cases, long follow up in two leading centres in Argentina.

Author information

1
Surgical Oncology Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: fsanchez@intramed.net.
2
Hospital de Gastroenterologia Bonorino Udaondo, Buenos Aires, Argentina. Electronic address: iseassoledad@hotmail.com.
3
Clinical Oncology Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: juanmanuel.oconnor@gmail.com.
4
Surgical Oncology Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: apairola@yahoo.com.
5
Clinical Oncology Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: matiemi@yahoo.com.
6
Hospital de Gastroenterologia Bonorino Udaondo, Buenos Aires, Argentina. Electronic address: mendezdoc@hotmail.com.
7
Hospital de Gastroenterologia Bonorino Udaondo, Buenos Aires, Argentina. Electronic address: mcoraglio@hotmail.com.
8
Statistitian Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: ja_mariani@hotmail.com.
9
Imagenologist Diagnostico Medico, Buenos Aires, Argentina. Electronic address: amdieguez@speedy.com.ar.
10
Hospital de Gastroenterologia Bonorino Udaondo, Buenos Aires, Argentina. Electronic address: enlroca@yahoo.com.ar.
11
Surgical Oncology Instituto Alexander Fleming, Buenos Aires, Argentina. Electronic address: huertaseduardo@yahoo.com.ar.

Abstract

BACKGROUND:

The non-surgical management in a selected group of rectal cancer patients has shown promising results with adequate follow up.

AIMS:

describing the results of the non-surgical management in patients with complete clinical response, with a close follow up.

METHODS:

Between 2006 and 2015, patients with rectal cancer, stages I-III, without metastasis, treated with neoadjuvant CRT/CT, who had clinical complete response were included. CCR was defined through digital palpation, endoscopy-based criteria and MRI. Follow up was set according to institutional guidelines.

RESULTS:

68 patients were included. Initial stage was assessed with MRI in 55/68 pts and EUS 11/68. Considering the recurrence risk factors 57.6% (29/68) were T2-3ab N0, 3.3% (2/68) were T4N0, 29% (20/68) were T3-4 N1-2, with 39.7% with positive MRC. Mean distance to the anal margin was 3cm. Chemoradiation included radiotherapy at 50.4cGy, and concurrent capecitabine. In 22% a fluoropirimidine and oxaliplatin-based schema was used as induction therapy. Median follow up was 37.5 months and response assessment time 9 weeks (5-19). Eleven patients recurred, 6 endoluminally, 3 developed mesorectal recurrence, and two distant failure. Five years DFS and OS were 76.3% and 93.8%.

CONCLUSIONS:

conservative management was feasible with close follow up in leading cancer centres. In this series, DFS and OS were comparable to the data already reported in the literature.

KEYWORDS:

Complete response; Neoadjuvant chemoradiation; Organ preserving; Rectal cancer

PMID:
27260329
DOI:
10.1016/j.dld.2016.05.012
[Indexed for MEDLINE]

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