BACKGROUND: To determine if preoperative radiation therapy allows sphincter preservation in the treatment of @entity5 . METHODS: Thirty six @entity1 with the diagnosis of invasive, resectable, primary @entity188 limited to the pelvis were enrolled on a Phase I/II trial of preoperative radiation therapy plus low anterior resection/coloanal @entity254 . By preoperative assessment, all @entity1 had invasive @entity5 (5,T2; 31,T3) involving the distal half of the rectum and clinically required an abdominoperineal resection. The median @entity5 size was 3.8 cm [range: 1.5-7 cm] and the median distance from the anal verge was 4 cm [range: 3-7 cm]. The whole pelvis received 46.80 Gy followed by a 3.60 Gy boost to the @entity5 bed. The median follow-up was 56 months [range: 4-121 months]. RESULTS: Of the 35 @entity1 who underwent resection, 5 (14%) had a complete pathologic response and 27 (77%) were able to successfully undergo a low anterior resection/coloanal @entity254 . The incidence of local failure was crude: 17% and 5-year actuarial: 21%. The 5-year actuarial survival was 64%. Analysis of sphincter function using a previously published scale was performed at the time of last follow-up in the 27 @entity1 who underwent a low anterior resection/coloanal @entity254 . Function was good or excellent in 85%. The median number of bowel movements/day was 2 (range: 0-8). CONCLUSIONS: Our data suggest that preoperative radiation therapy allows sphincter preservation in 77% of selected @entity1 who would otherwise require an abdominoperineal resection, and 85% have good to excellent sphincter function. Given the moderate local failure rate, we now routinely use preoperative combined modality therapy plus postoperative chemotherapy for @entity1 with clinical T3 disease.

Sphincter preservation in @entity5 with preoperative radiation therapy and coloanal XXXX : long term follow-up.

@entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'primary tumor', 'rectal cancer', 'tumors'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity188 :: ('MESH:D012004', 'Disease') :: ['adenocarcinoma of the rectum']
@entity254 :: (MESH:C563598,Disease) :: ['anastomosis']
