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Sphincter-sparing surgery after preoperative radiotherapy for low rectal cancers: feasibility, oncologic results and quality of life outcomes

Spataro, V
Anchisi, S
Sprangers, M
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Published in British journal of cancer. 2000, vol. 82, no. 6, p. 1131-7
Abstract The present study assesses the choice of surgical procedure, oncologic results and quality of life (QOL) outcomes in a retrospective cohort of 53 patients with low-lying rectal cancers (within 6 cm of the anal verge) treated surgically following preoperative radiotherapy (RT, median dose 45Gy) with or without concomitant 5-fluorouracil. QOL was assessed in 23 patients by using two questionnaires developed by the QOL Study Group of the European Organization for Research and Treatment of Cancer: EORTC QLQ-C30 and EORTC QLQ-CR38. After a median interval of 29 days from completion of RT, abdominoperineal resection (APR) was performed in 29 patients (55%), low anterior resection in 23 patients (20 with coloanal anastomosis) and transrectal excision in one patient. The 3-year actuarial overall survival and locoregional control rates were 71.4% and 77.5% respectively, with no differences observed between patients operated by APR or restorative procedures. For all scales of EORTC QLQ-C30 and EORTC QLQ-CR38, no significant differences in median scores were observed between the two surgical groups. Although patients having had APR tended to report a lower body image score (P = 0.12) and more sexual dysfunction in male patients, all APR patients tended to report better physical function, future perspective and global QOL. In conclusion, sphincter-sparing surgery after preoperative RT seems to be feasible, in routine practice, in a significant proportion of low rectal cancers without compromising the oncologic results. However, prospective studies are mandatory to confirm this finding and to clarify the putative QOL advantages of sphincter-conserving approaches.
Keywords AgedAnal CanalAntimetabolites, Antineoplastic/therapeutic useCohort StudiesCombined Modality TherapyFeasibility StudiesFemaleFluorouracil/therapeutic useHumansMaleMiddle AgedPreoperative CareQuality of LifeRectal Neoplasms/radiotherapy/surgeryRetrospective StudiesTreatment Outcome
PMID: 10735495
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Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
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ALLAL, Abdelkarim Said et al. Sphincter-sparing surgery after preoperative radiotherapy for low rectal cancers: feasibility, oncologic results and quality of life outcomes. In: British journal of cancer, 2000, vol. 82, n° 6, p. 1131-7. doi: 10.1054/bjoc.1999.1052 https://archive-ouverte.unige.ch/unige:48409

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Deposited on : 2015-03-24

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