Related Experiment Video
Updated: May 9, 2025
12:45
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
5.4K
Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer: A Retrospective Analysis.
Jacob F Wahba1, Gregory Knight2, Mohamed Husein3
1Faculty of Health Sciences, Wilfrid Laurier University, Waterloo, CAN.
Cureus
|April 29, 2025
Summary
Preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer achieved a 14% pathological complete response rate, with high rates of negative surgical margins (93%) and low local recurrence (6%). Distant metastasis remains a concern.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Locally advanced rectal cancer (LARC) requires multimodal treatment strategies.
- Preoperative chemoradiotherapy (CRT) is a standard approach for LARC.
- Evaluating outcomes in community cancer centers is crucial for real-world applicability.
Purpose of the Study:
- To assess the effectiveness and outcomes of preoperative chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).
- To analyze surgical margin status, pathological complete response (pCR), recurrence rates, and survival after preoperative CRT in a community setting.
Main Methods:
- Retrospective chart review of 120 patients with biopsy-proven rectal adenocarcinoma treated with CRT between January 2017 and June 2020.
- Standard preoperative radiotherapy (50.4 Gy/28 fractions) with concurrent capecitabine, followed by surgery 6-8 weeks later.
- Exclusion of patients with stage IV disease, non-curative intent surgery, or additional preoperative chemotherapy.
Main Results:
- A pathological complete response (pCR) rate of 14% was observed.
- R0 resection (negative margins) was achieved in 93% of patients.
- Local recurrence occurred in 6% of patients, while distant metastases developed in 23%, primarily to the liver and lungs. Cancer-specific survival (CSS) was 78% and overall survival (OS) was 75% at a median follow-up of 28 months.
Conclusions:
- Preoperative CRT in LARC patients at a community center yielded a 14% pCR rate, supporting its role in achieving high rates of R0 resection and low local recurrence.
- Despite favorable local control, the 23% rate of distant metastases highlights an ongoing challenge that requires further investigation and management strategies.
