Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up
A significant problem for long-term rectal cancer survivors may be the late toxicity of radiotherapy. It creates the possible risk of developing second primary malignancy and a theoretical decrease in overall survival. This study aimed to assess the influence of short-course preoperative radiotherap...
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MDPI AG
2021-06-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/9/7/725 |
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| author | Radoslaw Pach Piotr Richter Marek Sierzega Natalia Papp Antoni Szczepanik |
| author_facet | Radoslaw Pach Piotr Richter Marek Sierzega Natalia Papp Antoni Szczepanik |
| author_sort | Radoslaw Pach |
| collection | DOAJ |
| description | A significant problem for long-term rectal cancer survivors may be the late toxicity of radiotherapy. It creates the possible risk of developing second primary malignancy and a theoretical decrease in overall survival. This study aimed to assess the influence of short-course preoperative radiotherapy in patients with locally advanced rectal cancer on overall survival, local recurrence rate, and second malignancy at 18-year follow-up. The rectal cancer trial was conducted in a single tertiary center between February 1992 and June 2006. A total of 389 patients with locally advanced rectal cancer (cT2-cT4, cN0/+, cM0) were included in the study. Preoperative radiotherapy was conducted in 148 patients and 241 patients underwent surgery alone. The propensity-matched group consisted of 105 patients operated on after radiotherapy and 105 controls. The number of local recurrences was 7 (6.7%) in the preoperative radiotherapy group and 22 (21%) in the surgery alone group (<i>p</i> = 0.016). The 18-year survival analysis showed no survival benefit in the preoperative radiotherapy group (38% versus 48%, <i>p</i> = 0.107) but improved recurrence-free survival (81% versus 58%, <i>p</i> = 0.001). The preoperative short-course radiotherapy significantly decreases the risk of local recurrence in locally advanced rectal cancer and may improve recurrence-free survival without an increased risk of second primary malignancy. |
| first_indexed | 2024-03-10T10:05:50Z |
| format | Article |
| id | doaj.art-b8b402b437cd454eabea678fe0d1ef0f |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T10:05:50Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-b8b402b437cd454eabea678fe0d1ef0f2023-11-22T01:35:31ZengMDPI AGBiomedicines2227-90592021-06-019772510.3390/biomedicines9070725Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-UpRadoslaw Pach0Piotr Richter1Marek Sierzega2Natalia Papp3Antoni Szczepanik4Department of General, Oncological, Gastrointestinal and Transplantation Surgery, Medical College, Jagiellonian University, 30-688 Krakow, PolandDepartment of General, Oncological, Gastrointestinal and Transplantation Surgery, Medical College, Jagiellonian University, 30-688 Krakow, PolandDepartment of General, Oncological, Gastrointestinal and Transplantation Surgery, Medical College, Jagiellonian University, 30-688 Krakow, PolandFaculty of Medicine, Poznan University of Medical Sciences, 60-512 Poznań, PolandDepartment of General, Oncological, Gastrointestinal and Transplantation Surgery, Medical College, Jagiellonian University, 30-688 Krakow, PolandA significant problem for long-term rectal cancer survivors may be the late toxicity of radiotherapy. It creates the possible risk of developing second primary malignancy and a theoretical decrease in overall survival. This study aimed to assess the influence of short-course preoperative radiotherapy in patients with locally advanced rectal cancer on overall survival, local recurrence rate, and second malignancy at 18-year follow-up. The rectal cancer trial was conducted in a single tertiary center between February 1992 and June 2006. A total of 389 patients with locally advanced rectal cancer (cT2-cT4, cN0/+, cM0) were included in the study. Preoperative radiotherapy was conducted in 148 patients and 241 patients underwent surgery alone. The propensity-matched group consisted of 105 patients operated on after radiotherapy and 105 controls. The number of local recurrences was 7 (6.7%) in the preoperative radiotherapy group and 22 (21%) in the surgery alone group (<i>p</i> = 0.016). The 18-year survival analysis showed no survival benefit in the preoperative radiotherapy group (38% versus 48%, <i>p</i> = 0.107) but improved recurrence-free survival (81% versus 58%, <i>p</i> = 0.001). The preoperative short-course radiotherapy significantly decreases the risk of local recurrence in locally advanced rectal cancer and may improve recurrence-free survival without an increased risk of second primary malignancy.https://www.mdpi.com/2227-9059/9/7/725rectal cancerpreoperative radiotherapyoverall survivalrecurrence free survivalsecond primary neoplasms |
| spellingShingle | Radoslaw Pach Piotr Richter Marek Sierzega Natalia Papp Antoni Szczepanik Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up Biomedicines rectal cancer preoperative radiotherapy overall survival recurrence free survival second primary neoplasms |
| title | Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up |
| title_full | Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up |
| title_fullStr | Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up |
| title_full_unstemmed | Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up |
| title_short | Preoperative Short-Course Radiotherapy and Surgery versus Surgery Alone for Patients with Rectal Cancer: A Propensity Score-Matched Analysis at 18-Year Follow-Up |
| title_sort | preoperative short course radiotherapy and surgery versus surgery alone for patients with rectal cancer a propensity score matched analysis at 18 year follow up |
| topic | rectal cancer preoperative radiotherapy overall survival recurrence free survival second primary neoplasms |
| url | https://www.mdpi.com/2227-9059/9/7/725 |
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