[Utility of Preoperative Chemotherapy for Locally Advanced Colorectal Cancer]

Preoperative chemotherapy has been performed for locally advanced colorectal cancer, to achieve cytoreduction, local control, and prevention of distant metastasis. The regimens of mFOLFOX6/XELOX plus bevacizumab for 3 months have been adopted to succeed curative resection for borderline resectable colorectal cancer. We examined treatment results for locally advanced colorectal cancer without distant metastasis. Thirty-four patients were examined and the mean age was 62.7 years old. The cohort comprised of 23 cases of rectal cancer and 11 of sigmoid colon cancer. Thirty cases were diagnosed as cT4b and 25 cases were as cN+before chemotherapy. Stoma creations were performed in 26 patients before preoperative chemotherapy. Reduction ratio of the tumor diameter was 33.6±28.2%. The reduction in CEA was 38.5±39.4%, and the reduction in CA19-9 was 62.8±42.3%. There were 23 extended resections combined with involved organs including 8 total pelvic exenterations. Chemotherapeutic effect was diagnosed as Grade 1a or less, 20 cases; Grade 1b, 6 cases; Grade 2, 5 cases; Grade 3, 3 cases. Recurrence was found in 9 cases and 8 of them were Grade 1a or less. Overall 5-year survival rate was 74.6%. The utility of preoperative chemotherapy for locally advanced rectal cancer is suggested not only for local treatment but also systemic therapy, especially in chemotherapeutic effective cases.