PURPOSE: This prospective, nonrandomized study evaluates, with a seven-year median follow-up, the morbidity and the functional and oncologic results of conservative surgery after high-dose radiation for @entity5 of the lower third of the rectum of @entity1 who would otherwise have undergone abdominoperineal resection. METHODS: Between June 1990 and June 1996, 43 @entity1 with @entity420 were treated by preoperative radiotherapy (40 + 20 Gy delivered with three fields) and curative surgery. The mean distance from the anal verge was 50 (range, 25-60) mm, and none of the @entity5 was fixed (15 percent T2N0, 53 percent T3N0, 32 percent T3N1). RESULTS: Postoperative mortality (2 percent) and morbidity (35 percent) were not increased by high-dose preoperative radiation. Conservative surgery was done in 30 @entity1 (70 percent: 26 coloanal anastomoses and 4 low stapled anastomoses). After conservative surgery, long-term functional results showed 30 percent complete continence and 20 percent serious @entity322 . Four @entity1 had local recurrence as first development (13 percent). The seven-year overall survival rate was 53 percent, 62 percent after conservative surgery and 31 percent after abdominoperineal resection. The univariate analysis underscores the @entity5 response impact on long-term survival (pT<3 = 81 percent; @entity1803 = 35 percent; P = 0.0008). CONCLUSIONS: These long-term results confirm the feasibility of conservative surgery for low @entity189 after high-dose radiation. A prospective multicentric trial began in France in June 1996 to evaluate the reproducibility of these results.

Restorative and nonrestorative surgery for low XXXX after high-dose radiation: long-term oncologic and functional results.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1803 :: ('7694', 'Gene') :: ['pT3'] @entity322 :: ('MESH:D014549', 'Disease') :: ['incontinence'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'cancer', 'tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['rectal carcinoma'] @entity420 :: ('MESH:D000230', 'Disease') :: ['distal rectal adenocarcinoma']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
