Optimal preoperative assessment and surgery for rectal cancer may greatly limit the need for radiotherapy

• DOI: 10.1002/bjs.4210
• Publication Date: 2003-08-04T17:38:04Z
• Authors: M Simunovic; R Sexton; E Rempel; B J Moran; R J Heald
• Keywords: Preoperative care

Abstract Background Radiation is being used increasingly in the management of patients with rectal cancer. Over past decade Basingstoke Colorectal Research Unit has combined precision total mesorectal excision highly selective use preoperative radiotherapy. Methods One hundred and fifty consecutive who underwent major surgical for cancers all stages comprised study group. Preoperative clinical assessment was based largely on tumour size, fixation distance from anal verge. Only radiotherapy considered this only tumours judged to be at high risk fascia involvement. Results During a 5-year period 35 150 were selected irradiation. In non-irradiated local recurrence rate after median follow-up 870 (range 51–1903) days 2·6 per cent (three 115 patients), compared 17·1 (six patients) those chosen Sixty (52·2 cent) not irradiated node positive. The whole group 6·0 cent. Conclusion great majority undergoing cancer can managed without radiation therapy if surgery are performed optimally.