BACKGROUND: Radiation is being used increasingly in the management of patients with rectal cancer. Over the past decade the Basingstoke Colorectal Research Unit has combined precision total mesorectal excision with the highly selective use of preoperative radiotherapy. METHODS: One hundred and fifty consecutive patients who underwent major surgical excision for cancers of all stages comprised the study group. Preoperative clinical assessment was based largely on tumour size, fixation and distance from the anal verge. Only preoperative radiotherapy was considered and this only for tumours judged to be at high risk of mesorectal fascia involvement. RESULTS: During a 5-year period 35 of 150 patients were selected for preoperative irradiation. In the non-irradiated patients the local recurrence rate after a median follow-up period of 870 (range 51-1903) days was 2.6 per cent (three of 115 patients), compared with 17.1 per cent (six of 35 patients) in those chosen for irradiation. Sixty patients (52.2 per cent) who were not irradiated were node positive. The local recurrence rate for the whole group was 6.0 per cent. CONCLUSION: The great majority of patients undergoing major excision for rectal cancer can be managed without radiation therapy if the preoperative assessment of the mesorectal fascia and surgery are performed optimally. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
BACKGROUND: Radiation is being used increasingly in the management of patients with rectal cancer. Over the past decade the Basingstoke Colorectal Research Unit has combined precision total mesorectal excision with the highly selective use of preoperative radiotherapy. METHODS: One hundred and fifty consecutive patients who underwent major surgical excision for cancers of all stages comprised the study group. Preoperative clinical assessment was based largely on tumour size, fixation and distance from the anal verge. Only preoperative radiotherapy was considered and this only for tumours judged to be at high risk of mesorectal fascia involvement. RESULTS: During a 5-year period 35 of 150 patients were selected for preoperative irradiation. In the non-irradiated patients the local recurrence rate after a median follow-up period of 870 (range 51-1903) days was 2.6 per cent (three of 115 patients), compared with 17.1 per cent (six of 35 patients) in those chosen for irradiation. Sixty patients (52.2 per cent) who were not irradiated were node positive. The local recurrence rate for the whole group was 6.0 per cent. CONCLUSION: The great majority of patients undergoing major excision for rectal cancer can be managed without radiation therapy if the preoperative assessment of the mesorectal fascia and surgery are performed optimally. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors: Johannes Klose; Ignazio Tarantino; Thomas Schmidt; Thomas Bruckner; Yakup Kulu; Tobias Wagner; Martin Schneider; Markus W Büchler; Alexis Ulrich Journal: J Gastrointest Surg Date: 2015-03-31 Impact factor: 3.452
Authors: S Delgado; D Momblán; L Salvador; R Bravo; A Castells; A Ibarzabal; J M Piqué; A M Lacy Journal: Surg Endosc Date: 2004-08-26 Impact factor: 4.584
Authors: Dong Nyoung Son; Dong Jin Choi; Si Uk Woo; Jin Kim; Bo Ra Keom; Chul Hwan Kim; Se Jin Baek; Seon Hahn Kim Journal: World J Gastroenterol Date: 2013-01-28 Impact factor: 5.742