PURPOSE: @entity1 with cT2N0 @entity5 do not require adjuvant therapy. However, when a @entity1 refuses an abdominoperineal resection (APR), is there an alternative? The purpose of this trial is to determine whether preoperative external-beam radiation therapy can increase the rate of sphincter preservation for @entity1 with distal cT2N0 @entity188 . @entity1 AND METHODS: Between April 1988 and October 2003, 27 @entity1 with distal @entity420 staged T2 by clinical and/or endorectal ultrasound who were judged by the operating surgeon to require an APR were treated with preoperative pelvic radiation alone (50.4 Gy). Surgery was performed 4 to 7 weeks later. If pathologic positive pelvic nodes were identified, postoperative adjuvant chemotherapy was recommended. The median follow-up was 55 months (range, 9 to 140 months). RESULTS: The pathologic complete response rate was 15% and 78% of @entity1 underwent a sphincter-sparing procedure. The crude incidence of local failure for @entity1 undergoing a sphincter sparing procedure was 10% and the 5-year actuarial incidence was 13%. The actuarial 5-year survival for @entity1 undergoing sphincter preservation was as follows: disease-free, 77%; colostomy-free, 100%; and overall, 85%. Using the Memorial Sloan-Kettering Cancer Center sphincter function score, 54% of those undergoing a sphincter-sparing procedure had good/excellent bowel function at 12 to 24 months after surgery, and 77% had good/excellent function at 24 to 36 months after surgery. CONCLUSION: Our data suggest that for @entity1 with cT2N0 @entity5 who require an APR, preoperative pelvic radiation improves sphincter preservation without an apparent compromise in local control or survival.

Distal cT2N0 XXXX : is there an alternative to abdominoperineal resection?

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity420 :: ('MESH:D000230', 'Disease') :: ['rectal adenocarcinoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['distal rectal cancer'] @entity188 :: ('MESH:D012004', 'Disease') :: ['adenocarcinoma of the rectum']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
