open access

Vol 25, No 4 (2020)
Original research articles
Published online: 2020-07-01
Submitted: 2019-12-27
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Postoperative radio-chemotherapy for rectal cancer: A retrospective analysis from a tertiary referral hospital

Ewa Wasilewska-Teśluk, Monika Rucińska, Karolina Osowiecka, Iwona Ryniewicz-Zander, Beata Czeremszyńska, Krzysztof Gliński, Lucyna Kępka
DOI: 10.1016/j.rpor.2020.05.002
·
Rep Pract Oncol Radiother 2020;25(4):612-618.

open access

Vol 25, No 4 (2020)
Original research articles
Published online: 2020-07-01
Submitted: 2019-12-27

Abstract

Aim

To report results of postoperative radio-chemotherapy (RT-CHT) for rectal cancer (RC).

Background

Total mesorectal excision (TME) is an essential treatment method in rectal cancer (RC). Perioperative radiotherapy in locally advanced RC improves loco-regional free survival (LRFS). Preoperative radiotherapy is a preferred option; however, some patients are not referred for it. In case of the risk of loco-regional failure postoperative radio-chemotherapy (RT-CHT) is indicated.

Material and methods

Between 2004 and 2010, 182 patients with pathological stage II-III RC (TME performed — 41%, resection R0 — 88%, circumferential resection margin evaluated — 55.5% and was above 2 mm in 66% of them) received postoperative RT-CHT in our institution. Overall survival (OS) and LRFS were estimated with the Kaplan–Meier method. Univariate and multivariate analysis were performed to compare the impact of prognostic factors on survival.

Results

Five-year OS and LRFS rates were 63% and 85%, respectively. Loco-regional recurrence and isolated distant metastases rates were 11.5% and 19%, respectively. Multivariate analysis showed stage (III vs. II), HR: 2.3 (95% confidence interval [CI]: 1.4–3.8), p = 0.0001; extent of resection (R1−2 vs. R0), HR: 2.14 (95%CI: 1.14–3.99), p = 0.017, and age (>65 vs. ≤65 years), HR: 1.66 (95%CI: 1.06–2.61), p = 0.027 as prognostic factors for OS. Extent of resection (R1−2 vs. R0), HR: 3.65 (95%CI: 1.41–9.43), p = 0.008 had significant impact on LRFS.

Conclusion

Despite a suboptimal quality of surgery and pathological reports, the outcome in our series is close to that reported in the literature. We confirm a strong impact of the extent of resection on patient’s outcome, which confirms the pivotal role of surgery in the management of RC.

Abstract

Aim

To report results of postoperative radio-chemotherapy (RT-CHT) for rectal cancer (RC).

Background

Total mesorectal excision (TME) is an essential treatment method in rectal cancer (RC). Perioperative radiotherapy in locally advanced RC improves loco-regional free survival (LRFS). Preoperative radiotherapy is a preferred option; however, some patients are not referred for it. In case of the risk of loco-regional failure postoperative radio-chemotherapy (RT-CHT) is indicated.

Material and methods

Between 2004 and 2010, 182 patients with pathological stage II-III RC (TME performed — 41%, resection R0 — 88%, circumferential resection margin evaluated — 55.5% and was above 2 mm in 66% of them) received postoperative RT-CHT in our institution. Overall survival (OS) and LRFS were estimated with the Kaplan–Meier method. Univariate and multivariate analysis were performed to compare the impact of prognostic factors on survival.

Results

Five-year OS and LRFS rates were 63% and 85%, respectively. Loco-regional recurrence and isolated distant metastases rates were 11.5% and 19%, respectively. Multivariate analysis showed stage (III vs. II), HR: 2.3 (95% confidence interval [CI]: 1.4–3.8), p = 0.0001; extent of resection (R1−2 vs. R0), HR: 2.14 (95%CI: 1.14–3.99), p = 0.017, and age (>65 vs. ≤65 years), HR: 1.66 (95%CI: 1.06–2.61), p = 0.027 as prognostic factors for OS. Extent of resection (R1−2 vs. R0), HR: 3.65 (95%CI: 1.41–9.43), p = 0.008 had significant impact on LRFS.

Conclusion

Despite a suboptimal quality of surgery and pathological reports, the outcome in our series is close to that reported in the literature. We confirm a strong impact of the extent of resection on patient’s outcome, which confirms the pivotal role of surgery in the management of RC.

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Keywords

Rectal cancer; Total mesorectal excision; Postoperative radio-chemotherapy

About this article
Title

Postoperative radio-chemotherapy for rectal cancer: A retrospective analysis from a tertiary referral hospital

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 4 (2020)

Pages

612-618

Published online

2020-07-01

DOI

10.1016/j.rpor.2020.05.002

Bibliographic record

Rep Pract Oncol Radiother 2020;25(4):612-618.

Keywords

Rectal cancer
Total mesorectal excision
Postoperative radio-chemotherapy

Authors

Ewa Wasilewska-Teśluk
Monika Rucińska
Karolina Osowiecka
Iwona Ryniewicz-Zander
Beata Czeremszyńska
Krzysztof Gliński
Lucyna Kępka

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