Beyond total mesorectal excision in locally advanced rectal cancer with organ or pelvic side-wall involvement

2018 ◽  
Vol 44 (8) ◽  
pp. 1226-1232 ◽  
Author(s):  
A.B. Mariathasan ◽  
K. Boye ◽  
K.E. Giercksky ◽  
B. Brennhovd ◽  
H.P. Gullestad ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Locally Advanced ◽  
Side Wall ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Mesorectal Excision

Extended Total Mesorectal Excision (e-TME) for Locally Advanced Rectal Cancer

2021 ◽  
Author(s):  
Narendra Pandit ◽  
Kunal Bikram Deo ◽  
Sujan Gautam ◽  
Tek Narayan Yadav ◽  
Awaj Kafle ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Mesorectal Excision

scholarly journals Impact of Body Mass Index on Surgical and Oncological Outcomes in Laparoscopic Total Mesorectal Excision for Locally Advanced Rectal Cancer after Neoadjuvant 5-Fluorouracil-Based Chemoradiotherapy

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Yanwu Sun ◽  
Pan Chi
Keyword(s):  
Body Mass Index ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Resection Margin ◽  
Locally Advanced ◽  
Oncological Outcome ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Laparoscopic Total Mesorectal Excision ◽  
Mesorectal Excision

Aims.To evaluate the impact of body mass index (BMI) on the surgical outcome of laparoscopic total mesorectal excision (laTME) for locally advanced rectal cancer (LARC, clinically staged as UICC stage II/III) after neoadjuvant chemoradiotherapy (nCRT).Methods.312 LARC patients undergoing laTME after nCRT were divided into nonobese (BMI < 25.0 kg/m2,n=249) and obese (BMI ≥ 25.0 kg/m2,n=63) groups. Preoperative radiotherapy was delivered in 45–50.4 Gy/25f, 5 days/week, and concurrent chemotherapy using FOLFOX or CapeOX. Technical feasibility, postoperative and oncological outcome were compared between groups.Results.Obese patients had significantly longer operative time (P=0.004). There was no significant difference regarding estimated blood loss, conversion, postoperative recovery, and morbidities. Multivariate analysis demonstrated that higher ASA score and abdominoperineal resection were risk factors for postoperative complications and diverting stoma was a protective factor. The length of resection margin, circumferential resection margin involvement, and number of lymph node retrieved were comparable. With a median follow-up time of 55 months (ranging 20–102 months), oncological outcome was comparable in terms of overall survival, local recurrence, and distant metastasis.Conclusions.Obesity does not affect surgical or oncological outcome of laTME after nCRT. LaTME may be feasible and safe to obese LARC patients after nCRT in a specialized center.

Induction chemotherapy with mFOLFOXIRI in cT4N+ locally advanced rectal cancer: Subgroup analysis from a prospective trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16136-e16136
Author(s):  
Jianwei Zhang ◽  
Huabin Hu ◽  
Yue Cai ◽  
Xiaoyu Xie ◽  
Zehua Wu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Total Mesorectal Excision ◽  
Induction Chemotherapy ◽  
Locally Advanced ◽  
Prospective Trial ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Mesorectal Excision ◽  
Tumor Downstaging

e16136 Background: FOLFOXIRI had been recommended as induction treatment for patients with T4N+ rectal cancer in the latest NCCN guideline. However, no prospective study to support this recommendation in his population. Here, we tried to analyze the efficacy of FOLFOXIRI as induction chemotherapy in the subgroup of rectal cancer patients with T4N+ from a prospective trial. Methods: A phase II trial exploring the efficacy of mFOLFOXIRI as neoadjuvant chemotherapy in locally advanced rectal cancer had been conducted in our center recently. The subgroups of patients with clinical T4N+ rectal cancer were extracted for further analysis. All candidates were to receive 4 to 6 cycles of mFOLFOXIRI. MRI will be performed every two cycles to assess clinical responses. And then the patients would receive total mesorectal excision directly or proceed to chemoradiotherapy according to the result of restaging evaluation. Postoperative FOLFOX chemotherapy was recommended. The primary endpoint is the ratio of tumor downstaging to ypT0-2N0M0. Results: There were 27 patients with cT4N+. There were twenty male and 7 female, with the median age of 46 years old. MRF involved was observed in 14 patients. Neoadjuvant chemotherapy with mFOLFOXIRI was performed for at least 4 cycles. Six patients received radiotherapy before total mesorectal excision, including short-term radiation in 1 patient. R0 resection was achieved in all the patients (100%) and 24 (88.9%) of patients had received sphincter-saving operation. According to the pathologic result, all patients showed regression in the primary tumor (ypT0-3). The pCR rate was 22.2% (6/27) and the tumor downstaging (ypStage 0-I) rate was 29.6%. Another 13 (48.1%) patients showed downstaging to ypStage II. The main grade 3/4 adverse event was neutropenia (35.7%). With a median follow-up of 25 months, no local recurrence was observed. Only 3 patients developed distant metastasis. The 2-year survival rate for this group of population was 85.0%. Conclusions: mFOLFOXIRI showed high tumor downstaging rate in locally advanced rectal cancer. It could be reasonable to use mFOLFOXIRI as induction chemotherapy for cT4N+ rectal cancer patients. Clinical trial information: NCT02217020 . [Table: see text]

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