Navigation Links
Rectal Cancer Outcomes Best With Short-Course Radiation

Even with latest surgical techniques, therapy should come first, studies suggest

THURSDAY, March 5 (HealthDay News) -- For people with operable rectal cancer, the most effective treatment is a short course of radiation therapy followed by "high-quality surgery," according to a new study.

Surgery is the standard treatment for rectal cancer, but just removing the tumor leaves a risk of cancer recurrence in the same area, according to background information. Previous research has shown that radiotherapy and chemotherapy after surgery can reduce the risk of recurrence. However, radiotherapy is costly and can cause long-term complications such as impaired bowel function, incontinence and sexual dysfunction.

The study involved 1,350 rectal cancer patients in the United Kingdom, Canada, South Africa and New Zealand. Professor Robert Steele, of Ninewells Hospital in Dundee, Scotland, and his colleagues randomly assigned the participants to receive five daily treatments of radiotherapy followed by surgery, or to have surgery followed by 25 treatments of chemo-radiotherapy.

Three years after treatment, 4.4 percent of those who had received radiotherapy before surgery had a local recurrence of the cancer, compared with 10.6 percent of those who had received radiotherapy after surgery. The disease-free survival rate after three years was 77.5 percent for people who had received pre-surgery radiotherapy and 72 percent for those who had gotten post-surgery radiotherapy. There was no significant difference in overall survival -- 157 deaths in the pre-surgery radiotherapy group and 173 deaths in the post-surgery group.

The findings were published in this week's issue of The Lancet.

Another study in the same issue of the journal found that recent improvements in surgical techniques have improved rectal cancer patient outcomes. Professor Phil Quirke, of the University of Leeds, in the United Kingdom, and his colleagues assessed how circumferential resection margin and the plane of surgery (the amount of tissue removed around the tumor) affected cancer recurrence risk in 1,156 people.

Of that group, 128 (11 percent) had involvement of the circumferential resection margin -- the presence of a tumor within 1 millimeter of the circumferential margin, which is associated with a high risk of local recurrence and poor survival. The plane of surgery was good (mesorectal) in 604 patients (52 percent), intermediate (intramesorectal) in 398 (34 percent) and poor (muscularis propria plane) in 154 (13 percent).

Three years after surgery, cancer had recurred locally in 6 percent of those with a negative circumferential margin and in 17 percent who had a positive circumferential margin. Local recurrence occurred in 4 percent of people in the mesorectal group, 7 percent in the intramesorectal group and 13 percent in the muscularis propria plane group.

For any plane of surgery achieved, short-course radiotherapy before surgery reduced local recurrence by about half, the study found.

"At present, only 50 percent of rectal cancer surgery is done in the mesorectal plane, suggesting that a further decrease in local recurrence rates might be obtained by improving the plane of surgery achieved," the researchers concluded. "[This could] be achieved through education and surgical tuition."

The findings of these studies show that "perioperative radiation can mitigate but not eliminate the adverse effects of imperfect surgery," Dr. Robert Madoff, of the University of Minnesota, wrote in an accompanying comment in the journal. "The best outcomes occurred when preoperative radiation was followed by optimum surgery. … The next challenge is to understand which patient needs what therapy to maximize his or her chances for a cure."

More information

The American Cancer Society has more about colorectal cancer.

-- Robert Preidt

SOURCE: The Lancet, news release, March 6, 2009

Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. American College of Gastroenterology Issues Updated Colorectal Cancer Guidelines
2. No differences in survival or neonatal outcomes in pregnancy-associated colorectal cancer
3. Economy could reduce colorectal cancer screening rate
4. Gaps in colorectal cancer screening persist between whites and non-whites
5. Biomarker predicts disease recurrence in colorectal cancer
6. Long-Term Aspirin Use Seems to Protect Against Colorectal Lesions
7. Colorectal cancer: Immunological tests for more accurate detection of cancer precursors
8. Polymedco Introduces New Colorectal Cancer Educational Website
9. African-Americans have worse prognosis at colorectal cancer diagnosis
10. Hormone Therapy May Cut Colorectal Cancer Risk
11. Narrow-band imaging comparable to white light colonoscopy in differentiating colorectal polyps
Post Your Comments:
Related Image:
Rectal Cancer Outcomes Best With Short-Course Radiation
(Date:12/1/2015)... ... , ... With FCPX Overlay: Grit , users can apply a grit ... are truly endless, all with a click of a mouse. Each user has full ... depth of field and more, all within Final Cut Pro X. , With FCPX ...
(Date:12/1/2015)... ... December 01, 2015 , ... SonaCare Medical ... HSJ Acute Sector Innovation Award on November 18th. This prestigious award recognizes annually ... propose exciting enhancements to the medical landscape. , The UCLH team won the ...
(Date:11/30/2015)... ... 2015 , ... Olympic Gold Medalists and Celebrity Moms Dara ... various categories through traditional and social media marketing campaigns and other branding initiatives. ... Medal Moms who can connect with today’s most important consumer: mothers. In addition ...
(Date:11/30/2015)... City, NY (PRWEB) , ... December 01, 2015 ... ... honors Christina Colon as a 2015-2016 inductee into its VIP ... leadership in pharmacy. NAPW is the nation’s leading networking organization exclusively for professional ...
(Date:11/30/2015)... ... 30, 2015 , ... 1Heart Caregiver Services’ Executive Team actively ... Philippine American Chambers of Commerce held from November 6-8, 2015 at the Monte ... as an active delegate from the Philippine American Chamber of Commerce of Greater ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... 30, 2015   Royal Philips  (NYSE: ... of Radiology Solutions, a fully integrated, consultative approach ... customized, data-driven practice management approaches that combine imaging ... practices improve care delivery and reduce costs. Making ... of North America Annual Meeting (RSNA) in ...
(Date:11/30/2015)... 30, 2015 Nautilus Medical Inc. today announced ... platform ( ). The release of MatrixRay to ... 2015 (Radiology Society North America) in Chicago ... U.S. --> --> ... access to radiology studies worldwide via a peer-to-peer exchange ...
(Date:11/30/2015)... 30, 2015 (HK$,000)For the Six Months Ended 30 September 2015 2014RestatedChange%Turnover 545,575 ... , 421,979 , 384,242 , ... 34,719 , (18.3) Medical Insurance Administration Service ... 16.1 Medical Devices and Accessories Sales , 89,645 ... Herbal Medicines Sales , 2,822 , 2,917 ...
Breaking Medicine Technology: