Clinicopathologic features in rectal cancer treated by local excision and postoperative radiation therapy Journal Article


Authors: Minsky, B. D.; Enker, W. E.; Cohen, A. M.; Lauwers, G.
Article Title: Clinicopathologic features in rectal cancer treated by local excision and postoperative radiation therapy
Abstract: We report the impact of selected clinicopathologic features on local failure and disease-free survival in 22 patients with localized, mobile, primary resectable rectal cancer treated with local excision and postoperative radiation therapy. Full thickness local excisions with negative margins were performed in 21 patients. One patient had a transanal snare excision of a T1 polyp. Postoperatively patients received 4500-4950 cGy (median 4680 cGy) whole pelvis, and in 15 this was followed by a conedown of 360-1000 cGy (median 360 cGy). Two received 5-FU. Tumors were evaluated for size, gross appearance, distance from the anal verge, T stage, blood vessel invasion, lymphatic vessel invasion, and DNA content (ploidy, DNA index, and proliferation index). The median follow-up was 37 months (range 5-73). With increasing T stage there was a corresponding increase in local failure (T1: 0%, T2: 17%, and T3: 33%) and a decrease in disease-free survival (T1: 100%, T2: 67%, and T3: 50%). When accounting for the effect oft stage, tumors which were either BVI- or ulcerative were associated with an increase in local failure, and tumors which were ≤ 3 cm, ulcerative, or nonaneuploid were associated with a decrease in disease-free survival. However, none of the differences reached statistical significance. Although other clinicopathologic features may have an impact, T stage remains the most reliable clinicopathologic feature by which to predict local failure and disease-free survival in patients with rectal cancer who undergo local excision and postoperative radiation therapy.
Keywords: adult; cancer survival; clinical article; human tissue; aged; disease-free survival; cancer surgery; treatment failure; clinical feature; histopathology; cancer localization; fluorouracil; cancer radiotherapy; chemotherapy, adjuvant; radiotherapy, adjuvant; cancer staging; follow-up studies; neoplasm staging; adenocarcinoma; computer assisted tomography; antimetabolites, antineoplastic; radiotherapy dosage; time factors; dna, neoplasm; cancer size; brachytherapy; rectal neoplasms; rectum cancer; iridium 192; intravenous drug administration; rectal cancer; rectum; clinicopathologic correlation; conservative management; dna content; ploidies; prognosis; human; male; female; article
Journal Title: Radiation Medicine
Volume: 13
Issue: 5
ISSN: 0288-2043
Publisher: Springer  
Date Published: 1995-09-01
Start Page: 235
End Page: 241
Language: English
PUBMED: 8848558
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 28 August 2018 -- Source: Scopus
Citation Impact
MSK Authors
  1. Bruce Minsky
    306 Minsky
  2. Alfred M Cohen
    244 Cohen
  3. Warren E. Enker
    70 Enker
  4. Gregory Y. Lauwers
    24 Lauwers