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Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation.

Publication ,  Journal Article
Chakravarti, A; Compton, CC; Shellito, PC; Wood, WC; Landry, J; Machuta, SR; Kaufman, D; Ancukiewicz, M; Willett, CG
Published in: Ann Surg
July 1999

OBJECTIVE: The long-term outcomes of patients undergoing local excision with or without pelvic irradiation were examined to define the role of adjuvant irradiation after local excision of T1 and T2 rectal cancers. METHODS: Ninety-nine patients with T1 or T2 rectal cancers underwent local excision with or without adjuvant irradiation at Massachusetts General Hospital and Emory University Hospital between January 1966 and January 1997. Of these, 52 patients were treated by local excision alone and 47 patients by local excision plus adjuvant irradiation. Twenty-six of these 47 patients were treated by irradiation in combination with 5-fluorouracil chemotherapy. The outcomes of these groups were compared. RESULTS: The 5-year actuarial local control and recurrence-free survival rates were 72% and 66%, respectively, for the local excision alone group and 90% and 74%, respectively, for the adjuvant irradiation group. This improvement in outcome was evident despite the presence of a higher-risk patient population in the adjuvant irradiation group. Adverse pathologic features such as poorly differentiated histology and lymphatic or blood vessel invasion decreased local control and recurrence-free survival rates in the local excision only group. Adjuvant irradiation significantly improved 5-year outcomes in patients with high-risk pathologic features. Four cases of late local recurrence were seen at 64, 72, 86, and 91 months in the adjuvant irradiation group. CONCLUSIONS: The authors recommend adjuvant chemoradiation for all patients undergoing local excision for T2 tumors, and for T1 tumors with high-risk pathologic features. The four cases of late local failures beyond 5 years in the adjuvant irradiation group underscores the need for careful long-term follow-up in these patients.

Duke Scholars

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Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

July 1999

Volume

230

Issue

1

Start / End Page

49 / 54

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Surgery
  • Rectal Neoplasms
  • Radiotherapy, Adjuvant
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
 

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APA
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MLA
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Chakravarti, A., Compton, C. C., Shellito, P. C., Wood, W. C., Landry, J., Machuta, S. R., … Willett, C. G. (1999). Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation. Ann Surg, 230(1), 49–54. https://doi.org/10.1097/00000658-199907000-00008
Chakravarti, A., C. C. Compton, P. C. Shellito, W. C. Wood, J. Landry, S. R. Machuta, D. Kaufman, M. Ancukiewicz, and C. G. Willett. “Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation.Ann Surg 230, no. 1 (July 1999): 49–54. https://doi.org/10.1097/00000658-199907000-00008.
Chakravarti A, Compton CC, Shellito PC, Wood WC, Landry J, Machuta SR, et al. Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation. Ann Surg. 1999 Jul;230(1):49–54.
Chakravarti, A., et al. “Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation.Ann Surg, vol. 230, no. 1, July 1999, pp. 49–54. Pubmed, doi:10.1097/00000658-199907000-00008.
Chakravarti A, Compton CC, Shellito PC, Wood WC, Landry J, Machuta SR, Kaufman D, Ancukiewicz M, Willett CG. Long-term follow-up of patients with rectal cancer managed by local excision with and without adjuvant irradiation. Ann Surg. 1999 Jul;230(1):49–54.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

July 1999

Volume

230

Issue

1

Start / End Page

49 / 54

Location

United States

Related Subject Headings

  • Time Factors
  • Survival Rate
  • Surgery
  • Rectal Neoplasms
  • Radiotherapy, Adjuvant
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies