Biomaterial Database

Local excision and postoperative radiation therapy for rectal cancer. 1994

B D Minsky, and W E Enker, and A M Cohen, and G Lauwers

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York 10021.

OBJECTIVE We report the results of 22 patients with localized, mobile, resectable rectal cancer treated with local excision and postoperative radiation therapy. METHODS Margins were negative in 21 patients and unassessable in 1. The median follow-up was 37 months (range: 5-73 months). The median tumor size was 3.0 cm (range: 1-6.2 cm). Full-thickness local excisions were performed in 21 patients: transanal, 11; transsphincteric, 2; and posterior proctotomy (Kraske), 8. All margins were inked and were microscopically negative in 21. One patient had a transanal snare excision of a T1 polyp. Postoperatively patients received 4,500-4,950 cGy (median: 4,680 cGy) whole pelvis, and in 15 this was followed by a conedown to 360-1,000 cGy (median: 360 cGy). RESULTS The 4-year actuarial survival was 79% and the 4-year actuarial colostomy-free survival was 73%. The incidence of local failure was 18% and increased with T stage: T1: 0/4 (0%); T2: 2/12 (17%); and T3: 2/6 (33%). Four patients developed local failure at 6, 10, 15, and 21 months. Of the four, three underwent salvage APR and were locally controlled at 6, 33, and 58 months following salvage surgery. The incidence of abdominal failure was 18% and distant failure was 18%. Of the 15 eligible patients, 14 (93%) had good or excellent sphincter function. CONCLUSIONS The results of local excision and postoperative radiation therapy are encouraging; however, more experience is needed to determine if this approach ultimately has similar local control and survival rates as standard surgery.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011182	Postoperative Care	The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)	Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011878	Radiotherapy	The use of IONIZING RADIATION to treat malignant NEOPLASMS and some benign conditions.	Radiotherapy, Targeted,Targeted Radiotherapy,Radiation Therapy,Radiation Therapy, Targeted,Radiation Treatment,Targeted Radiation Therapy,Radiation Therapies,Radiation Therapies, Targeted,Radiation Treatments,Radiotherapies,Radiotherapies, Targeted,Targeted Radiation Therapies,Targeted Radiotherapies,Therapies, Radiation,Therapies, Targeted Radiation,Therapy, Radiation,Therapy, Targeted Radiation,Treatment, Radiation
D011879	Radiotherapy Dosage	The total amount of radiation absorbed by tissues as a result of radiotherapy.	Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D012004	Rectal Neoplasms	Tumors or cancer of the RECTUM.	Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D001918	Brachytherapy	A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues.	Curietherapy,Implant Radiotherapy,Plaque Therapy, Radioisotope,Radioisotope Brachytherapy,Radiotherapy, Interstitial,Radiotherapy, Intracavity,Radiotherapy, Surface,Brachytherapy, Radioisotope,Interstitial Radiotherapy,Intracavity Radiotherapy,Radioisotope Plaque Therapy,Radiotherapy, Implant,Surface Radiotherapy,Therapy, Radioisotope Plaque
D003131	Combined Modality Therapy	The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.	Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D005260	Female		Females
D005472	Fluorouracil	A pyrimidine analog that is an antineoplastic antimetabolite. It interferes with DNA synthesis by blocking the THYMIDYLATE SYNTHETASE conversion of deoxyuridylic acid to thymidylic acid.	5-FU,5-FU Lederle,5-FU Medac,5-Fluorouracil,5-Fluorouracil-Biosyn,5-HU Hexal,5FU,Adrucil,Carac,Efudex,Efudix,Fluoro-Uracile ICN,Fluoroplex,Fluorouracil Mononitrate,Fluorouracil Monopotassium Salt,Fluorouracil Monosodium Salt,Fluorouracil Potassium Salt,Fluorouracil-GRY,Fluorouracile Dakota,Fluorouracilo Ferrer Far,Fluoruracil,Fluracedyl,Flurodex,Haemato-FU,Neofluor,Onkofluor,Ribofluor,5 FU Lederle,5 FU Medac,5 Fluorouracil,5 Fluorouracil Biosyn,5 HU Hexal,Dakota, Fluorouracile,Fluoro Uracile ICN,Fluorouracil GRY,Haemato FU