[Preoperative chemoradiotherapy for advanced lower rectal carcinoma]

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Advanced lower rectal carcinoma presents significant treatment challenges.
• Neoadjuvant therapies aim to improve surgical outcomes and preserve organ function.

Purpose of the Study:

• To evaluate the safety and efficacy of preoperative chemoradiotherapy in patients with advanced lower rectal carcinoma.
• To assess the impact on tumor response, lymph node status, and surgical margins.
• To determine the feasibility of autonomic nerve-preserving resections.

Main Methods:

• Fourteen patients with advanced lower rectal carcinoma received preoperative chemoradiotherapy (30 Gy radiation, oral uracil-tegafur chemotherapy).
• Tumor characteristics, lymph node status (cN0-cN3), and response were assessed.
• Autonomic nerve-preserving resections with targeted lymphadenectomy were performed.

Main Results:

• Partial response observed in 9 patients; stable disease in 5. Perirectal lymph nodes downsized in 4 patients.
• Margins to the anal verge were prolonged by a mean of 0.81 cm in 7 patients.
• Histopathology showed primary tumors were not effective in 9 cases, partially effective in 5; lymph nodes exhibited necrosis and fibrosis.

Conclusions:

• Preoperative chemoradiotherapy is safe and facilitates autonomic nerve preservation and sphincter function in advanced lower rectal cancer.
• The study highlights the need for optimized radiation, chemotherapy, and lymphadenectomy in future research.