Cic edizioni internazionali
Il Giornale di Chirurgia

Trattamento del carcinoma del retto localmente avanzato mediante chemio-radioterapia preoperatoria in combinazione con radioterapia intraoperatoria (IORT)

Articolo, 32 - 34
Tag this article
Abstract
Full text PDF
Object: The use of aggressive multimodality treatment including preoperative chemo-radiation, surgery, and intraoperative radiotherapy (IORT) has been shown to impact on relapse and survival in patients with unresectable and recurrent rectal cancer. The aim of this study was to determine the outcome of this approach in locally advanced primary rectal cancer.
Patients and methods: The study cohort comprised 53 patients (38 men and 15 women; median age 65 years, range 40-80) with clinical T3-4NxM0 adenocarcinoma of the rectum who received preoperative chemo-radiation, radical surgery (40 low anterior resection and 13 abdominoperineal resection), and IORT at our Institution between January 2000 and December 2005. Median distance of the tumor from the anal verge was 5 cm (range 2-13). According to the cTNM staging system 13 (25%) of the tumors were cT4 and 13 (25%) were cN positive. Univariate and multivariate analysis for disease free survival (DFS) and overall survival (OS) were performed.
Results: Median follow-up was 54 months (range 10-111), and 5-year DFS and OS were 67,0% and 78,7% respectively. Univariate analysis of survival showed that DFS and OS were 76,7% and 86,7% in patients with cT3 tumors and 38,8% and 55,5% in patients with cT4 tumors (P<0,01). At multivariate analysis of survival cT, cN, and tumor regression grade (TRG) were independent prognostic factors. Postoperative morbidity and mortality rate were 33,9% and 3,8% respectively.
Conclusions: Multimodality treatment including IORT is highly effective in locally advanced rectal cancer. Due to its toxicity this approach should be balanced with the risk of local recurrence.

Vol. XLI (No. 1) 2020 January - February

  1. Laparoscopic Roux-en-Y gastric bypass in the treatment of obesity: evidence based update through randomized clinical trials and meta-analyses
    Morales-Maza J., Rodriguez-Quintero J.H., Sanchez-Morales G.E., Sanchez Garcia-Ramos E., Romero-Velez G., Aguilar-Frasco J.L., Pimienta-Ibarra A.S., Alvarez-Bautista F.E., Leon P., Hernandez-Acevedo J.D., Del Angel-Millan G., Sierra M.
  2. Retroperitoneal sarcomas: from diagnosis to treatment. Case series and review of the literature
    Mantas D., Garmpis N., Polychroni D., Garmpi A., Damaskos C., Liakea A., Sypsa G., Kouskos E.
  3. The discriminative properties of erythrocyte anisocytosis in patients with resectable malignant pancreatic masses compared with an age and gender matched control group
    Akturk O.M., Çakir M.
  4. Diagnostic and therapeutic role of laparoscopy in perforated peptic ulcer in the elderly patients
    Giordano A., Prosperi P., Alemanno G., Bergamini C., Bruscino A., Valeri A.
  5. The role of laparoscopic surgery in isolated adrenal metastasis: our personal experience
    Frattolillo G., Paradiso G., Scarano Catanzaro V., Giordano L., Avantifiori R., D'Ermo G., Letizia C., De Toma G.
  6. Advances in bioengineering of complex tissues: state of the art of mucosae decellularization protocols
    Rizzo M.I., Contardi C., Esposito M., Zama M.
  7. An analysis of missed cases with surgical emergencies admitted in non-surgical departments. Case series and а review of the literature
    Popivanov G., Cirocchi R., Popov G., Stefanovski P., Andonova R., Kjossev K., Tonchev P., Tabakov M., Penkov M., Ivanov P., Mutafchiyski V.
  8. The evolution of robotic arm-assisted arthroplasty in Greece
    Koutserimpas C., Dretakis K.
  9. Current role of open surgery in adrenal tumors
    Chiappini A., Frattolillo G., Paradiso G., De Gori A., Scarano Catanzaro V., Avantifiori R., Fiori E., De Toma G.
  10. Preoperative fasting - “nihil per os” a difficult myth to break down: a randomized controlled study
    Panebianco A., Laforgia R., Volpi A., Punzo C., Vacca G., Minafra M., Di Salvo M., Pezzolla A.
  11. Sentinel lymph node biopsy with intraoperative touch imprint cytology (TIC) in breast cancer: experience of a mild-volume center
    Marano A., Sodano B., Vitiello C., Martini A.M., Baldassarre F., Siciliano A., Iannaci G.
  12. Spontaneous transdiaphragmatic intercostal hernia: clinical considerations and management
    Lonardo M.T., Frezzotti F., Collalti M., Natili A., Metere A.
  13. Systemic immune response after open tension-free inguinal hernia repair under different anesthetic alternatives: a prospective comparative study
    Symeonidis D., Diamantis A., Baloyiannis I., Tzovaras G., Tepetes K.
  14. Minilaparotomic incision for haemorrhagic corpus luteum: a case report
    Leanza V., Mininni C., Di Grazia F.M., Genovese F., Carbonaro A., Leanza G., Palumbo M.
  15. Conservative management of streptococcal necrotizing periorbital fasciitis following primary VZV infection
    Kontou E., Bontzos G., Triantafyllou D., Garnavou-Xirou C., Ragkousis A., Xirou T.
  16. Relief of hemorrhoid symptoms: pilot study of a new topical ally
    Gaj F., Bianchi F.P., Passannanti D., Tedesco D.
  17. Topical use of tranexamic acid in primary total knee arthroplasty: a comparative study
    Besiris G.TH., Koutserimpas C., Karamitros A., Karaiskos I., Tsakalou D., Raptis K., Kourelis K., Paxinos O., Kotsirakis A., Vlasis K.
  18. Insights in clinical examination and diagnosis of Athletic Pubalgia
    Koutserimpas C., Ioannidis A., Konstantinidis M.K., Makris M.C., Antonakopoulos F., Mazarakis A., Papagelopoulos P.J., Vlasis K., Konstantinidis M.K.
Last Viewed articles: la lista degli ultimi x visitati.
  1. Trattamento del carcinoma del retto localmente avanzato mediante chemio-radioterapia preoperatoria in combinazione con radioterapia intraoperatoria (IORT)
    De Marchi F., De Paoli A., Frustaci S., Cannizzaro R., Sigon R., Boz G., Buonadonna A., Fornasaring M., Belluco C., Innocente R., Rossi C.
credits