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Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984.

Publication ,  Journal Article
Greenberg, JA; Shibata, D; Herndon, JE; Steele, GD; Mayer, R; Bleday, R
Published in: Dis Colon Rectum
August 2008

PURPOSE: The efficacy of local excision in the treatment of some early-stage distal rectal cancers is still being debated, because few high-quality, long-term prospective data on outcomes are available. METHODS: Fifty-nine patients with T1 lesions were treated with local excision alone, whereas 51 patients with T2 lesions received external beam irradiation (5,400 cGY) and 5-fluorouracil (500 mg/m(2) intravenously Days 1-3, Days 29-31) after local excision. Kaplan-Meier curves were used to estimate the primary outcomes. The log-rank test and Cox's proportional hazards model were used to compare subgroups relative to these outcomes. RESULTS: With a median follow-up of 7.1 (range, 2.1-11.4) years, ten-year rates of overall survival were 84 percent for patients with T1 and 66 percent for T2 rectal cancer. Disease-free survival was 75 percent for T1 and 64 percent for T2 disease. Local recurrence rates for patients with T1 and T2 lesions were 8 and 18 percent, respectively, and rates of distant metastases were 5 percent for T1 and 12 percent for T2 lesions. T stage was a statistically significant predictor of overall survival (P = 0.04) and approached statistical significance as a predictor of disease-free survival (P = 0.07). CONCLUSIONS: Local excision alone for T1 rectal adenocarcinomas is associated with low recurrence and good survival rates that remain durable with long-term follow-up. T2 lesions treated via local excision and adjuvant therapy are associated with higher recurrence rates.

Duke Scholars

Published In

Dis Colon Rectum

DOI

EISSN

1530-0358

Publication Date

August 2008

Volume

51

Issue

8

Start / End Page

1185 / 1191

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Surgery
  • Rectal Neoplasms
  • Radiotherapy Dosage
  • Proportional Hazards Models
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neoplasm Metastasis
  • Middle Aged
 

Citation

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Chicago
ICMJE
MLA
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Greenberg, J. A., Shibata, D., Herndon, J. E., Steele, G. D., Mayer, R., & Bleday, R. (2008). Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984. Dis Colon Rectum, 51(8), 1185–1191. https://doi.org/10.1007/s10350-008-9231-6
Greenberg, Jacob A., David Shibata, James E. Herndon, Glenn D. Steele, Robert Mayer, and Ronald Bleday. “Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984.Dis Colon Rectum 51, no. 8 (August 2008): 1185–91. https://doi.org/10.1007/s10350-008-9231-6.
Greenberg JA, Shibata D, Herndon JE, Steele GD, Mayer R, Bleday R. Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984. Dis Colon Rectum. 2008 Aug;51(8):1185–91.
Greenberg, Jacob A., et al. “Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984.Dis Colon Rectum, vol. 51, no. 8, Aug. 2008, pp. 1185–91. Pubmed, doi:10.1007/s10350-008-9231-6.
Greenberg JA, Shibata D, Herndon JE, Steele GD, Mayer R, Bleday R. Local excision of distal rectal cancer: an update of cancer and leukemia group B 8984. Dis Colon Rectum. 2008 Aug;51(8):1185–1191.

Published In

Dis Colon Rectum

DOI

EISSN

1530-0358

Publication Date

August 2008

Volume

51

Issue

8

Start / End Page

1185 / 1191

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Surgery
  • Rectal Neoplasms
  • Radiotherapy Dosage
  • Proportional Hazards Models
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neoplasm Metastasis
  • Middle Aged