Preoperative adjuvant radiation with chemotherapy for rectal cancer: its impact on stage of disease and the role of endorectal ultrasound

dc.contributor.authorBernini, A.en_US
dc.contributor.authorDeen, K.I.en_US
dc.contributor.authorMadoff, R.D.en_US
dc.contributor.authorWong, W.D.en_US
dc.creator.corporateauthorSociety of Surgical Oncology (US)en_US
dc.date.accessioned2014-10-29T09:14:49Z
dc.date.available2014-10-29T09:14:49Z
dc.date.issued1996en_US
dc.descriptionIndexed in MEDLINE
dc.description.abstractBACKGROUND: Preoperative adjuvant radiation combined with chemotherapy is a recent development in the management of patients with rectalcancer invading perirectal tissue and regional lymph nodes. This study was performed to assess the impact of preoperative adjuvant therapy in patients judged by endorectal ultrasound to have extramural invasion of rectal cancer and/or regional lymph node involvement on tumor regression in bowel wall and lymph nodes. The predictive value of ultrasound in staging wall penetration and lymph node involvement after preoperative adjuvanttherapy was also assessed. METHODS: Patients (n = 43) were selected by ultrasound to have preoperative irradiation (4,500-5,040 cGy over 5-6 weeks). In 30 patients this was combined with 5-fluorouracil, 370 mg/m(2), for 5 days in the first and last weeks of irradiation. Pretreatment ultrasound was compared with pathologic findings in the resected specimen in all patients. Twenty-one were assessed by ultrasound after adjuvant therapy and findings compared with histology. RESULTS: Downstaging was seen in 23 (53%) patients with wall invasion and in 23 (72%) of 32 patients with lymph node involvement. Overall, downstaging was achieved in 30 (70%). Positive predictive values of ultrasound after irradiation were 72% and 56% for wall penetration and lymph node status, respectively. Negative predictive values of ultrasound after irradiation were 100% and 82%, respectively. CONCLUSION: In the majority of patients with rectal cancer invading perirectal tissues or lymph nodes, lesions may be downstaged by preoperative adjuvant therapy. Endorectal ultrasound after adjuvant therapy for rectal cancer is of a lesser predictive value chiefly because of overstaging.
dc.identifier.citationAnnals of Surgical Oncology. 1996; 3(2): pp.131-135en_US
dc.identifier.departmentSurgeryen_US
dc.identifier.issn1068-9265 (Print)en_US
dc.identifier.issn1534-4681 (Electronic)en_US
dc.identifier.urihttp://repository.kln.ac.lk/handle/123456789/1286
dc.publisherSpringer Internationalen_US
dc.subjectRectal Neoplasms
dc.subjectRectal Neoplasms-pathology
dc.subjectRectal Neoplasms-therapy
dc.subjectRectal Neoplasms-ultrasonography
dc.subjectRectum-ultrasonography
dc.subjectRadiotherapy, Adjuvant
dc.subjectAntimetabolites, Antineoplastic-therapeutic use
dc.subjectCombined Modality Therapy
dc.subjectFluorouracil-therapeutic use
dc.subjectNeoplasm Staging
dc.subjectPredictive Value of Tests
dc.titlePreoperative adjuvant radiation with chemotherapy for rectal cancer: its impact on stage of disease and the role of endorectal ultrasounden_US
dc.typeArticleen_US

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