Short coursepreoperative radiotherapy and long interval before surgery: impact on local control in locally advanced rectal cancer: LTP19

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Aim:We investigated the effect of a long interval before surgery after SCR in patients with resectable rectal cancer.Method:Thirty-five patients with high risk rectal cancer receivedpre-operative SCR. Surgery was planned 4/6 weeks after completion of radiotherapy. The response to radiation therapy was measured by tumour regression grade on the surgical specimens.Results:Pre-treatment staging was as follow: 13 T3Nx, 16 T3N0, 4 T3N1, 2 T2N0. The mean distance from the anal verge was 6 cm. The mean interval between SCR and surgery was 44 days. An AR was performed in 29 patients and an APR in 6. Post-operative complications occurred in 16 patients. Two patients (5.7%) died post-operatively. Downsizing occurred in all cases; downstaging in 28 (80%). TRG was as follows: 3 TRG1, 7 TRG2, 11 TRG3, 12 TRG4, 2 TRG5. At a median follow-up of 31 months three patients had died of their disease, six were alive with disease, 24 were alive and disease free.Conclusion:The long interval after SCR downsizes rectal cancer. Complete response is rare. TRG12 scores seem increasing with an interval larger than 6 weeks.

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