The Results of Adjuvant Chemoradiotherapy in Patients With Stage Ii-Iii Rectum Carcinomas: Retrospective Analysis

Abstract

We aimed to investigate the factors affecting recurrence and survival rate in patients with stage II-III rectum carcinomas. Between January 1998 and December 2003, 164 patients having chemoradiotherapy with stage II-III rectum carcinomas were retrospectively evaluated in this study. We recorded the clinical/pathological data and surgical and medical therapeutic options. Median age 56 (range 22-82), 86 (52.4%) female and 78 (47.6%) male patients were included in this study. 70 patients (42.7%) were stage II, 94 patients (57.3%) were stage III according to the TNM classification. We carried out the 5-Fluorouracil / Folic acid (FUFA) as chemotherapeutic agents and radiotherapy protocol in all patients. Local recurrence was seen in 16 (9.8%), distant metastases in 35 (21.3%) patients, and both local recurrence and distant metastases were seen in 6 (3.7%) patients. The liver was the most involved organ for distant metastases. While involved lymph nodes, stage, histological grade, and surgical procedures played a statistically significant role on local recurrence, only stage was seen to have an important role on distant metastases. The median follow-up period was 50 month and 5 year overall survival rate was 68.34% and disease free survival rate was 63.82%. When analyzing the parameters effecting the overall and disease free survivals; involved lymph node, stage, histological grade, and surgical therapeutic option were found to be statistically significant in one variable analyses method. Multivariate analysis revealed that stage, histological grade and surgical procedures effects general survival rate. Only histological grade and surgical procedure were found to be effective in disease free survival in multivariate analyses. In considering these results, the type of surgical procedure and histological grade has an important role in local recurrence and disease free survival.