Local Excision of Distal Rectal Cancer: An Update of Cancer and Leukemia Group B 8984

Authors:
  • DSDavid Shibata
    David Shibata
  • JHJames E. Herndon
    James E. Herndon
  • GSGlenn D. Steele
    Glenn D. Steele
  • RMRobert Mayer
    Robert Mayer
Publisher website
Google Scholar
Abstract
Hereas 51 patients with T2 lesions received external beam irradiation (5,400 cGY) and 5-fluorouracil (500 mg/m2 intravenously Days 1-3, Days 29-31) after local excision. Kaplan-Meier curves were used to estimate the primary outcomes. The log-rank test and Cox's proportional hazards model were used to compare subgroups relative to these outcomes. Results: With a median follow-up of 7.1 (range, 2.1-11.4) years, ten-year rates of overall survival were 84 percent for patients with T1 and 66 percent for T2 rectal cancer. Disease-free survival was 75 percent for T1 and 64 percent for T2 disease. Local recurrence rates for patients with T1 and T2 lesions were 8 and 18 percent, respectively, and rates of distant metastases were 5 percent for T1 and 12 percent for T2 lesions. T stage was a statistically significant predictor of overall survival (P= 0.04) and approached statistical significance as a predictor of disease-free survival (P= 0.07). Conclusions: Local excision alone for T1 rectal adenocarcinomas is associated with low recurrence and good survival rates that remain durable with long-term follow-up. T2 lesions treatedvialocal excision and adjuvant therapy are associated with higher recurrence rates. Read at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, June 2 to 6, 2007. e-mail: rbleday@partners.org © The ASCRS 2008...

This publication has 18 references indexed in Scilit: