SPHINCTER SAVING AFTER PREOPERATIVE CHEMORADIATION FOR LOCALLY ADVANCED LOW LYING RECTAL CANCER: PRELIMINARY RESULTS

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OMRANIPOUR R.; ABASAHL A.A.GH.; AMOUZGAR HASHEMI F.; KAZEMIAN A.; SAMIEI MANESH F.; HADAD P.

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Journal: Iranian Journal of Surgery Year:2005 | Volume:13 | Issue:2 (35) Page(s): 49-56

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Title

SPHINCTER SAVING AFTER PREOPERATIVE CHEMORADIATION FOR LOCALLY ADVANCED LOW LYING RECTAL CANCER: PRELIMINARY RESULTS

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Keywords

RECTAL CANCERQ4

SPHINCTER SAVINGQ4

COMBINED CHEMORADIATIONQ4

Abstract

Introduction & Objective: To evaluate the impact of preoperative external radiation therapy combined with systemic chemotherapy on sphincter preservation and local control in locally advanced low lying (<5 cm from anal verge) RECTAL CANCER.Materials & Methods: Between 1999 and 2002,32 consecutive patients (22 male, 10 female, mean age 49, range 31-85) with biopsy proven locally advanced low lying RECTAL CANCER were treated with preoperative 5FU (750 mg/m2/day, first and fifth week of radiation) and external beam radiation (45 GY in 25 fractions over5 weeks) followed by radical resection. Surgery was performed 4-6 weeks after the end of chemoradiation.The mean tumor distance from anal verge was 2.1 centimeter (range 0.5-5 cm). A temporary stoma was performed in 7 patients. Mean follow up was 29 months (range 8 - 54).Results: There was no major acute toxicity following chemoradiation and all patients completed their scheduled preoperative therapy. A complete pathologic response to preoperative chemoradiation was confirmed in 3 patients (9%).The pathologic tumor stages in the remaining patients were: T3N0 (n=5, 17%), T3N1 (n=4, 14%), T4N0 (n=12, 41 %), T4N1 (n=8, 28%).Sphincter saving surgical was done on 23 patients had a procedure but sphincter was finally preserved in 21 patients (66%). A perfect continence was achieved in 18 patients (86% of cases). There were 2 (6%) perioperative mortality and 11 (34%) preoperative morbidity. In 4 patients a reoperation was required (anastomotic fistula and perineal abscess n=1, pelvic & abdominal abscess n=1, fecal peritonitis n=1, gastrointestinal bleeding n=1).At a mean follow up of 29 month local recurrence was observed in 2 patient (6.2 %) and distant metastases in 5 patients (16%).Conclusions: Preoperative chemoradiation for locally advanced RECTAL CANCER may provide higher rate of sphincter preservation.

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APA: Copy

OMRANIPOUR, R., ABASAHL, A.A.GH., AMOUZGAR HASHEMI, F., KAZEMIAN, A., SAMIEI MANESH, F., & HADAD, P.. (2005). SPHINCTER SAVING AFTER PREOPERATIVE CHEMORADIATION FOR LOCALLY ADVANCED LOW LYING RECTAL CANCER: PRELIMINARY RESULTS. IRANIAN JOURNAL OF SURGERY, 13(2 (35)), 49-56. SID. https://sid.ir/paper/112891/en

Vancouver: Copy

OMRANIPOUR R., ABASAHL A.A.GH., AMOUZGAR HASHEMI F., KAZEMIAN A., SAMIEI MANESH F., HADAD P.. SPHINCTER SAVING AFTER PREOPERATIVE CHEMORADIATION FOR LOCALLY ADVANCED LOW LYING RECTAL CANCER: PRELIMINARY RESULTS. IRANIAN JOURNAL OF SURGERY[Internet]. 2005;13(2 (35)):49-56. Available from: https://sid.ir/paper/112891/en

IEEE: Copy

R. OMRANIPOUR, A.A.GH. ABASAHL, F. AMOUZGAR HASHEMI, A. KAZEMIAN, F. SAMIEI MANESH, and P. HADAD, “SPHINCTER SAVING AFTER PREOPERATIVE CHEMORADIATION FOR LOCALLY ADVANCED LOW LYING RECTAL CANCER: PRELIMINARY RESULTS,” IRANIAN JOURNAL OF SURGERY, vol. 13, no. 2 (35), pp. 49–56, 2005, [Online]. Available: https://sid.ir/paper/112891/en

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