Original Paper

Preoperative Radiotherapy Has No Value for Patients with T2-3, N0 Adenocarcinomas of the Rectum
Floris T.J. Ferenschild^a, Imro Dawson^a, Eelco J.R. de Graaf^a, Johannes H.W. de Wilt^b, Geert W.M. Tetteroo<sup>a

a</sup>Department of Surgery, IJsselland Hospital, Capelle a/d IJssel, and
^bDepartment of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

Address of Corresponding Author

Dig Surg 2009;26:291-296 (DOI: 10.1159/000227771)

  Key Words

• Total mesorectal excision
• Local recurrence
• Rectal cancer
• Carcinoma
• Radiotherapy
• Neoadjuvant treatment
• Adjuvant treatment

  Abstract

Background: Treatment of rectal cancer with preoperative radiotherapy followed by total mesorectal excision is nowadays the standard treatment. It reduces local recurrences and improves overall survival. However, in patients with T2-3, N0 rectal cancer, the role of preoperative radiotherapy remains controversial. The aim of this study was to review the benefit of radiotherapy in T2 and T3, N0 rectal cancer patients. Methods: Between 1996 and 2003, 103 patients with T2-3, N0 rectal cancer were identified in our prospective database. This study evaluated time to local recurrence, distant metastases and overall survival. Results: Median follow-up was 4.3 years. The 5-year local control rate was 94%. The 5-year overall survival was 65%. The 5-year disease-free survival rate was 82%. Preoperative radiotherapy did not show any statistical differences. Abdominal perineal resection and T3 tumors negatively influenced overall survival (p = 0.02). Advanced age was of significant importance in overall survival. Conclusions: Preoperative radiotherapy does not seem to be of significant importance in patients with T2-3, N0 rectal cancer regarding local recurrence and survival. Since preoperative radiotherapy is associated with short- and long-term morbidity, patients with T2-3, N0 tumors should be identified and treated with surgery alone.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Geert W.M. Tetteroo, MD, PhD
Department of Surgery, IJsselland Hospital
PO Box 690
NL-2900 AR Capelle a/d IJssel (The Netherlands)
Tel. +31 10 258 5066, Fax +31 10 258 5064, E-Mail gtetteroo@ysl.nl

  Article Information

Received: January 9, 2009
Accepted: May 8, 2009
Published online: July 8, 2009
Number of Print Pages : 6
Number of Figures : 4, Number of Tables : 2, Number of References : 31