scholarly journals The short term feasibility of abdominoperineal resection with prostatectomy for locally advanced rectal cancer: open and laparoscopic cases report

2015 ◽  
Vol 5 (1) ◽  
pp. 20-25
Author(s):  
Ryota Nakanishi ◽  
Ikuo Takahashi ◽  
Yuichiro Kajiwara ◽  
Takashi Motomura ◽  
Yoshihiko Fujinaka ◽  
...  
2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14598-14598
Author(s):  
T. Z. Mohran ◽  
H. A. Rayad

14598 Objectives: To evaluate the influence of pre-operative chemo-radiation on resectability of locally advanced rectal cancer and the possibility of performing sphincter- sparing surgery in cases not suitable for this procedures. Methods: 30 patients with rectal carcinoma with either border line respectability or not suitable for primary sphincter sparing surgery. Performance status > 60, adequate bone marrow reserve and adequate hepatic and renal functions. All patients had been staged by radiological studies and endoscopies. Treatment: All patients were treated by combined chemo-radiation. Radiotherapy with dose of 45 Gray in 25 fractions over 5 weeks. Chemotherapy with 5-flurouracil 500 mg/m2 I.V infusion over 2 hours and leucovorin immediately before radiation setting for first 5 days of the first week and the first 5 days of the last week of radiation. Patients were evaluated 4–6 weeks after treatment. Operable patients were subjected to abdominoperineal resection (APR) or low anterior resection (AR). Toxicity was evaluated using WHO Common Toxicity Criteria. Results: 30 patients were included; the median age was 48 years. Partial response was reported in 63.4% of patients and stable disease was reported in 33.3% of patients while progressive disease was reported in only one patient. Low anterior resection (AR) had been performed in 8 patients out of 12 (66.2%) who had initially not suitable for primary sphincter preservation, while abdominoperineal resection (APR) had been performed in 11 patients out of 18 patients (61.1%) who had initially border line resectability. Tumor down staging was achieved in 66% of patients. Tumor stage was identified as the only significant prognostic factors in response. Local control rate at 18 months were 85%. Actuarial overall survival for patient with curative resection at 18 months, were 85%. Toxicities included G3 leucopenia in 10% of patients, Diarrhea G3 in 13.3% of patients. Conclusion: Preoperative chemo-radiotherapy is an effective treatment in inducing down-staging of locally advanced rectal cancer patients and enhances curative resection and sphincter preserving procedures. Keyword: Colorectal cancer; Chemo- radiotherapy No significant financial relationships to disclose.


2015 ◽  
Vol 32 (4) ◽  
pp. 275-283 ◽  
Author(s):  
Takuya Matsumoto ◽  
Suguru Hasegawa ◽  
Masazumi Zaima ◽  
Naoya Inoue ◽  
Yoshiharu Sakai

Aim: The efficacy of neoadjuvant chemotherapy without radiation (NAC) in the treatment of rectal cancer remains unclear. This retrospective study was aimed at determining the pathological complete response rate and short-term outcomes of NAC in patients with locally advanced rectal cancer. Patients and Methods: We collected data on 159 consecutive patients treated for rectal cancer (cT3/cT4a, cN+, and cM0 status) at five tertiary referral hospitals between 2005 and 2010. Pathological complete response (pCR) and safety were assessed as the main outcomes in 124 eligible patients comprising 15 who received NAC (NAC group) and 109 who received no neoadjuvant chemotherapy (non-NAC group). Results: In the NAC group, 2 patients (13.3%) achieved a pCR (95% confidence interval: 1.7-40.5%) and 3 patients (20%) experienced grade 3/4 adverse events. No significant differences were found between the NAC and non-NAC groups in terms of short-term outcomes, including R0 proportion (100 vs. 96.3%, p = 0.45) and postoperative grade 3/4 complications (13.3 vs. 18.4%, p = 0.63). Conclusions: Neoadjuvant systemic chemotherapy without radiation appears to be safe, without worsening short-term outcomes, in patients with locally advanced rectal cancer. A further study is needed to verify these findings in larger samples.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jintian Song ◽  
Yi Wang ◽  
Hui Yu ◽  
Liang Zheng ◽  
Xiongchao Cai ◽  
...  

Objective. To investigate clinical benefit and safety of neoadjuvant chemotherapy (NAC) plus bevacizumab combined with total mesorectal excision (TME) in treating patients with BRAF-mutated locally advanced rectal cancer (LARC). Methods. This study included LARC patients with BRAF mutation admitted to the Oncology Department of Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, between June 2013 and December 2018. Patients in the control group received a standard treatment regimen of TME combined with NAC ( n = 45 ), and patients in the observation group received NAC plus bevacizumab combined with TME ( n = 55 ). The short-term clinical efficacy of the two groups after NAC treatment was observed and compared, including differences in the pathological downstaging rate. The incidence of perioperative complications and adverse reactions during neoadjuvant therapy was compared to evaluate the safety of the treatment. Besides, the relapse-free survival (RFS) and overall survival (OS) of patients were analyzed to evaluate the long-term clinical benefit of the treatment. Results. Compared with the control group, the ypT staging rate ( p = 0.014 ) in the observation group was markedly lower. In addition, patients in the observation group had a prominently lower overall incidence of complications ( p < 0.001 ) during the perioperative period and a remarkably lower incidence of leukopenia ( p = 0.037 ) during neoadjuvant therapy. In terms of long-term clinical benefit, the RFS of patients in the observation group was evidently longer ( p = 0.037 ) than that in the control group. Conclusion. Compared with TME plus NAC treatment, the short-term and long-term clinical benefits are higher and safety is more favorable of NAC plus bevacizumab combined with TME in treating LARC patients.


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