Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press6110.17650/2220-3478-2012-0-4-21-25ORIGINAL REPORTSОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯВозможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишкиВозможности сфинктеросохраняющего лечения больных местно-распространенным первично-неоперабельным раком прямой кишкиBarsukovYu. A.БарсуковЮ. А.
Russian Federation
GordeyevS. S.ГордеевС. С.
Russian Federation
ss.netoncology@gmail.comTkachevS. I.ТкачевС. И.
Russian Federation
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowФГБУ «РОНЦ им. Н.Н. Блохина» РАМН, МоскваDepartment of Oncology, Faculty of Therapeutics, I.M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaГБОУ ВПО «Первый МГМУ им. И.М. Сеченова» Минздрава России010320121421252802201528022015Copyright ©; 2012, ABV-pressCopyright ©; 2012, АБВ-пресс2012ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/61

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.

 

 

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