Neoadjuvant chemoradiotherapy has a significant role in downstaging cancer. It improves the local control of the disease and can make conservative resection of rectal cancer possible. We enrolled 114 patients with subperitoneal rectal cancer who underwent neoadjuvant chemoradio-therapy and radical excision with total mesorectal excision (TME). The primary endpoint was oncological outcomes and the secondary endpoint was surgical outcomes.We evaluate the experience of a multidisciplinary team and the role of neoadjuvant chemoradiotherapy in integrated treatment of cancer of the subperitoneal rectum. Surgical procedures performed were abdominal perineal resection in 4 cases (3.5%), anterior resection in 89 cases (78%), Hartmann's procedure in 5 cases (4.4%), and ultralow resection with coloanal anastomosis and diverting stoma in 16 patients (14%). Local recurrence occurred in 6 patients (5.2%), the overall survival was 71.9% at 5 years and disease-free survival was about 60%. The effect of pathological downstaging amounted to 58.8%, including cPR. The pathologic complete remission occurred in 8.8% of cases. The outcomes of neoadjuvant therapy can be achieved when this treatment is associated with correct surgical technique with TME and the prognosis is defined by an anatomopathological examination performed according to Quirke's protocol.

Colorectal cancer in the elderly patient: The role of neo-adjuvant therapy / Dodaro, CONCETTA ANNA; Calogero, Armando; Tammaro, Vincenzo; Pellegrino, Tommaso; Lionetti, Ruggero; Campanile, Silvia; Menkulazi, Marsela; Ciccozzi, Massimo; Iannicelli, ANNA MARIA; Giallauria, Francesco; Sagnelli, Caterina. - In: OPEN MEDICINE. - ISSN 2391-5463. - 14:1(2019), pp. 607-612. [10.1515/med-2019-0068]

Colorectal cancer in the elderly patient: The role of neo-adjuvant therapy

Concetta Anna Dodaro;Armando Calogero
;
Vincenzo Tammaro;PELLEGRINO, TOMMASO;Silvia Campanile;Marsela Menkulazi;Anna Maria Iannicelli;Francesco Giallauria;
2019

Abstract

Neoadjuvant chemoradiotherapy has a significant role in downstaging cancer. It improves the local control of the disease and can make conservative resection of rectal cancer possible. We enrolled 114 patients with subperitoneal rectal cancer who underwent neoadjuvant chemoradio-therapy and radical excision with total mesorectal excision (TME). The primary endpoint was oncological outcomes and the secondary endpoint was surgical outcomes.We evaluate the experience of a multidisciplinary team and the role of neoadjuvant chemoradiotherapy in integrated treatment of cancer of the subperitoneal rectum. Surgical procedures performed were abdominal perineal resection in 4 cases (3.5%), anterior resection in 89 cases (78%), Hartmann's procedure in 5 cases (4.4%), and ultralow resection with coloanal anastomosis and diverting stoma in 16 patients (14%). Local recurrence occurred in 6 patients (5.2%), the overall survival was 71.9% at 5 years and disease-free survival was about 60%. The effect of pathological downstaging amounted to 58.8%, including cPR. The pathologic complete remission occurred in 8.8% of cases. The outcomes of neoadjuvant therapy can be achieved when this treatment is associated with correct surgical technique with TME and the prognosis is defined by an anatomopathological examination performed according to Quirke's protocol.
2019
Colorectal cancer in the elderly patient: The role of neo-adjuvant therapy / Dodaro, CONCETTA ANNA; Calogero, Armando; Tammaro, Vincenzo; Pellegrino, Tommaso; Lionetti, Ruggero; Campanile, Silvia; Menkulazi, Marsela; Ciccozzi, Massimo; Iannicelli, ANNA MARIA; Giallauria, Francesco; Sagnelli, Caterina. - In: OPEN MEDICINE. - ISSN 2391-5463. - 14:1(2019), pp. 607-612. [10.1515/med-2019-0068]
File in questo prodotto:
File Dimensione Formato  
med-2019-0068.pdf

accesso aperto

Descrizione: Articolo principale
Tipologia: Documento in Post-print
Licenza: Dominio pubblico
Dimensione 538.43 kB
Formato Adobe PDF
538.43 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/758270
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 7
social impact