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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Preoperative therapy in patients prospectively declared to require an APR

Preoperative therapy in patients prospectively declared to require an APR
  Wagman R1 Rouanet P2 Hyams DM3 Kuvshinoff B4 Valentini V5 Francois Y6 Grann A7 Sauer R8 Gambacorta M9 Rengan R10
Treatment RT RT CMT CMT CMT RT CMT CMT CMT RT
Total number enrolled 36 37 59* 37 83 201 72 392 54 27
Number who underwent surgery 35 27 59 36 81 34 72 NR 54 27
Number judged to need an APR 36 37 40 37 47 34* 35 105 20 27
Number with T3 disease 31 (86%) 12 (32%) NR (100%) NR 83 (66%)  62 (44%) 72 (100%) NR 52 (96%) 0 (all cT2)
Number who underwent LAR and/or coloanal anastomosis 27 (77%) 17 (63%) 30 (75%) 28 (78%) 31 (66%) 15 (44%) 68 (94%) 41 (39%) 13 (65%) 21 (78%)
Percent local failure 17 8 NR 11 10 12 2 7 4 10
Percent survival 64% 5-year 83% 2-year NR 87%Δ 72% 5-year 75% 3-year 95% 3-year  78% 5-year 92% 2-year 86% 5-year
Number evaluable for sphincter function analysis 27 (77%) 14 (52%) NR NR 63 82§ 21 NR NR 21
Sphincter function 85% good to excellent 75% perfect NR NR 6% moderate soilage 78% normal 81% good to excellent NR NR 77% good to excellent at 2 to 3 years
APR: abdominoperineal resection; RT: radiation therapy; CMT: combined modality therapy; NR: data not reported; cT2: clinical (and endoscopy) stage T2.
* These data are from an early report of National Surgical Adjuvant Breast and Bowel Project (NSABP) R-03 that included 59 patients randomized to the preoperative arm, 40 of whom were judged to require APR. Data on patients in the postoperative arm are not included.
¶ Data from a preliminary report of the preoperative therapy arm of a randomized German study comparing preoperative and postoperative chemoradiotherapy.
Δ Disease-free survival with a median follow-up of 12 months.
References:
  1. Wagman R, Minsky BD, Cohen AM, et al. Sphincter preservation in rectal cancer with preoperative radiation therapy and coloanal anastomosis: long term follow-up. Int J Radiat Oncol Biol Phys 1998; 42:51.
  2. Rouanet P, Saint-Aubert B, Lemanski C, et al. Restorative and nonrestorative surgery for low rectal cancer after high-dose radiation: long-term oncologic and functional results. Dis Colon Rectum 2002; 45:305.
  3. Hyams DM, Mamounas EP, Petrelli N, et al. A clinical trial to evaluate the worth of preoperative multimodality therapy in patients with operable carcinoma of the rectum: a progress report of National Surgical Breast and Bowel Project Protocol R-03. Dis Colon Rectum 1997; 40:131.
  4. Kuvshinoff B, Maghfoor I, Miedema B, et al. Distal margin requirements after preoperative chemoradiotherapy for distal rectal carcinomas: are < or = 1 cm distal margins sufficient? Ann Surg Oncol 2001; 8:163.
  5. Valentini V, Coco C, Picciocchi A, et al. Preoperative chemoradiation for extraperitoneal T3 rectal cancer: acute toxicity, tumor response, and sphincter preservation. Int J Radiat Oncol Biol Phys 1998; 40:1067.
  6. Francois Y, Nemoz CJ, Baulieux J, et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer: the Lyon R90-01 randomized trial. J Clin Oncol 1999; 17:2396.
  7. Grann A, Feng C, Wong D, et al. Preoperative combined modality therapy for clinically resectable uT3 rectal adenocarcinoma. Int J Radiat Oncol Biol Phys 2001; 49:987.
  8. Sauer R. Adjuvant versus neoadjuvant combined modality treatment for locally advanced rectal cancer: first results of the German rectal cancer study (CAO/ARO/AIO-94). Int J Radiat Oncol Biol Phys 2003; 57(2 suppl): S124.
  9. Gambacorta M, Valentini V, Morganti AG, et al. Chemoradiation with raltitrexed (Tomudex) in preoperative treatment of stage II-III resectable rectal cancer: a phase II study. Int J Radiat Oncol Biol Phys 2004; 60:130.
  10. Rengan R, Paty P, Wong WD, et al. Distal cT2N0 rectal cancer: is there an alternative to abdominoperineal resection? J Clin Oncol 2005; 23:4905.
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