Initial results of treatment of rectal cancer using the neoadjuvant treatment

Abstract

Introduction. Treatment of rectal cancer needs additional preoperative improvements that would decrease tumor volume and move away the lower edge of the tumor from a dentate line, allowing a higher percentage of operability and higher percentage of AR for APR and sterilize potential locoregional tumor deposits. Surgery can accomplish these improvements by using radio and chemotherapy. Patients and Methods. From September, 2011 to September, 2013, 153 patients with rectal cancer were treated. Neoadjuvant radio and chemotherapy by the Swedish protocol were applied in 20 patients (13.07%) with T 2-4 stages. There were fifteen men (75%) and five women (25%), average age was 59.28 years. Long course therapy occurred in fifteen (75%) and short course in five patients (25%). When compared to the previous two-year period, the percentage of inoperable cancers was decreased by 0.9% (p = 0.61) during the period of application of neoadjuvant therapy. There were also some other differences: a number of APR was 19, i.e. decreased by 3.85% (p = 0.83) or for 10 patients when compared to the previous two-year period, when there was 29 APR. Conclusion. Neoadjuvant therapy may convert up to 60% (3 of 5) of inoperable patients into an operable group. The percentage of APR is lower by 3.5% (p = 0.83), i.e. 10 patients when compared to the previous two-year period and neoadjuvant radio and chemotherapy does not affect the anastomosis healing process and / or the occurrence of fistula and / or abdominal collection.

Keywords

• cancer
• rectum
• surgery
• neoadjuvant treatment