Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки

The aim of this study was to compare results of sphincter-sparing operations (SSO) and abdominoperineal resections (APR) in patients  undergoing combined treatment for unresectable locally-advanced rectal cancer.Methods. During September 2007 – January 2011 59 patients were enrolled. Original treatm...

Full description

Bibliographic Details
Main Authors: Yu. A. Barsukov, S. S. Gordeyev, S. I. Tkachev
Format: Article
Language:Russian
Published: “ABV-press” Publishing house”, LLC 2015-02-01
Series:Тазовая хирургия и онкология
Subjects:
Online Access:https://ok.abvpress.ru/jour/article/view/61
_version_ 1797759229335961600
author Yu. A. Barsukov
S. S. Gordeyev
S. I. Tkachev
author_facet Yu. A. Barsukov
S. S. Gordeyev
S. I. Tkachev
author_sort Yu. A. Barsukov
collection DOAJ
description The aim of this study was to compare results of sphincter-sparing operations (SSO) and abdominoperineal resections (APR) in patients  undergoing combined treatment for unresectable locally-advanced rectal cancer.Methods. During September 2007 – January 2011 59 patients were enrolled. Original treatment scheme (RF patent № 2414936) was developed including radiotherapy 40 Gy in 4 Gy fractions, capecitabine 650 mg/m2 bid per os days 1-22, oxaliplatin 50 mg/m2 iv days 3, 10, 17, local hyperthermia on days 8, 12, 15, 17, 2 applications of metronidazole 10 g/m2 per rectum in a polymeric composition. Surgery was carried out following 6–8 weeks. SSO were carried out in 36 patients, APR in 23 patients. Study endpoints included 2-year OS and DFS, local recurrence and distant metastases rate, postoperative complications rate.Results. No significant differences in survival were observed: 2-year OS was 93.2 and 85.6 % (log- rank test p = 0.157) for SSO and APR groups accordingly, 2-year DFS was 88 and 71.9 % (log-rank test p = 0.064). Four (11.1 %) patients in SSO group and 4 (17.4 %) patients in APR group (р = 0.5511) developed local recurrences, 4 (11.1 %) and 7 (30.4 %) (р = 0.1293) developed distant metastases. Postoperative complications rate was 27.8 % (n = 10) and 39.1 % (n = 9) (р = 0.5181) in SSO and APR groups accordingly.Conclusions. Sphincter-sparting surgery is justified for unresectable locally advanced rectal cancer when technically feasible.
first_indexed 2024-03-12T18:41:24Z
format Article
id doaj.art-05f4763114ee42fcbd6d18842c86912c
institution Directory Open Access Journal
issn 2686-9594
language Russian
last_indexed 2024-03-12T18:41:24Z
publishDate 2015-02-01
publisher “ABV-press” Publishing house”, LLC
record_format Article
series Тазовая хирургия и онкология
spelling doaj.art-05f4763114ee42fcbd6d18842c86912c2023-08-02T07:48:57Zrus“ABV-press” Publishing house”, LLCТазовая хирургия и онкология2686-95942015-02-0104212510.17650/2220-3478-2012-0-4-21-2555Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишкиYu. A. Barsukov0S. S. Gordeyev1S. I. Tkachev2N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowDepartment of Oncology, Faculty of Therapeutics, I.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaN.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowThe aim of this study was to compare results of sphincter-sparing operations (SSO) and abdominoperineal resections (APR) in patients  undergoing combined treatment for unresectable locally-advanced rectal cancer.Methods. During September 2007 – January 2011 59 patients were enrolled. Original treatment scheme (RF patent № 2414936) was developed including radiotherapy 40 Gy in 4 Gy fractions, capecitabine 650 mg/m2 bid per os days 1-22, oxaliplatin 50 mg/m2 iv days 3, 10, 17, local hyperthermia on days 8, 12, 15, 17, 2 applications of metronidazole 10 g/m2 per rectum in a polymeric composition. Surgery was carried out following 6–8 weeks. SSO were carried out in 36 patients, APR in 23 patients. Study endpoints included 2-year OS and DFS, local recurrence and distant metastases rate, postoperative complications rate.Results. No significant differences in survival were observed: 2-year OS was 93.2 and 85.6 % (log- rank test p = 0.157) for SSO and APR groups accordingly, 2-year DFS was 88 and 71.9 % (log-rank test p = 0.064). Four (11.1 %) patients in SSO group and 4 (17.4 %) patients in APR group (р = 0.5511) developed local recurrences, 4 (11.1 %) and 7 (30.4 %) (р = 0.1293) developed distant metastases. Postoperative complications rate was 27.8 % (n = 10) and 39.1 % (n = 9) (р = 0.5181) in SSO and APR groups accordingly.Conclusions. Sphincter-sparting surgery is justified for unresectable locally advanced rectal cancer when technically feasible.https://ok.abvpress.ru/jour/article/view/61rectal cancerunresectable cancercombined treatmentsphincter-sparing treatment
spellingShingle Yu. A. Barsukov
S. S. Gordeyev
S. I. Tkachev
Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки
Тазовая хирургия и онкология
rectal cancer
unresectable cancer
combined treatment
sphincter-sparing treatment
title Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки
title_full Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки
title_fullStr Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки
title_full_unstemmed Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки
title_short Возможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишки
title_sort возможности сфинктеросохраняющего лечения больных местно распространенным первично неоперабельным раком прямой кишки
topic rectal cancer
unresectable cancer
combined treatment
sphincter-sparing treatment
url https://ok.abvpress.ru/jour/article/view/61
work_keys_str_mv AT yuabarsukov vozmožnostisfinkterosohranâûŝegolečeniâbolʹnyhmestnorasprostranennympervičnoneoperabelʹnymrakomprâmojkiški
AT ssgordeyev vozmožnostisfinkterosohranâûŝegolečeniâbolʹnyhmestnorasprostranennympervičnoneoperabelʹnymrakomprâmojkiški
AT sitkachev vozmožnostisfinkterosohranâûŝegolečeniâbolʹnyhmestnorasprostranennympervičnoneoperabelʹnymrakomprâmojkiški