J Med Assoc Thai 2009; 92 (11):1423

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The Surgical Outcome of Preoperative Chemoradiation Therapy for Ultra Low Rectal Cancer
Boonnuch W Mail, Lohsiriwat V , Akaraviputh T , Chinswangwatanakul V , Lohsiriwat D

Objective: To evaluate the surgical outcome of preoperative long-course chemoradiation therapy (PCRT) in
patients with ultra low rectal cancer.

Material and Method: Medical records of patients with rectal adenocarcinoma located within the length of
5 cm from the anal verge, who underwent elective oncological resection between 2003 and 2006 at Siriraj
Hospital, were reviewed. PCRT was performed in some patients based on tumor characteristics and surgeon’s
decision. Rate of sphincter preservation and other surgical outcomes were assessed.

Results: Ninety-three patients with an average age of 60 years were studied. Twenty-seven (29%) received
PCRT. There was no difference in demographic data and location of the tumor between PCRT and non-PCRT
group. Patients with PCRT had a smaller size of tumor (2.6 vs. 5.0 cm, p < 0.001) and better tumor staging
(p < 0.001). Complete pathological response was found in four patients with PCRT (15%). However, there
was no significant difference in SPP rate between PCRT and non-PCRT group (37% vs. 36%, p = 0.95). Other
surgical outcomes between the two groups were also not different.

Conclusion: PCRT did not increase rate of sphincter preservation in patients with low rectal cancer.

Keywords: Chemoradiation therapy, Drug therapy, Preoperative care, Radiotherapy, Rectal cancer, Rectal
neoplasms, Sphincter preservation

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