Control of pelvic symptoms in patients with rectal cancer and synchronous metastases.
Gastroenterol Clin Biol
; 33(12): 1106-13, 2009 Dec.
Article
in En
| MEDLINE
| ID: mdl-19423254
ABSTRACT
OBJECTIVE:
The optimal treatment strategy for rectal cancer (RC) with synchronous metastases remains an issue of debate. The aim of this study was to evaluate the impact of surgery and radiation on the control of pelvic symptoms in this setting.METHODS:
Consecutive patients with RC and synchronous metastases were retrospectively assessed and divided into four treatment groups surgical resection of rectal tumor (S); radiotherapy with/without chemotherapy followed by surgery (CRTS); chemoradiotherapy (CRT); and chemotherapy only (CT). Each group was evaluated in terms of duration of pelvic symptom-free periods (relative to overall survival).RESULTS:
A total of 96 patients were evaluated S n=30; CRTS n=21; CRT n=27; and CT n=18. After treatment, pelvic symptoms persisted in 14.7% patients (S=0%, CRTS=7.1%, CRT=31.8%, CT=25%; P=0.01). The relative pelvic symptom-free periods were 93.0% in the S group, 83.1% in the CRTS group, 53.0% in the CRT group and 53.2% in the CT group (P<0.01). On multivariate analysis, only surgical treatment correlated with a significant relative pelvic symptom-free period (P<0.01), with an adjusted hazards ratio of 2.80 [95% CI 1.79-4.39].CONCLUSION:
Our results suggest that rectal resection was the most effective therapeutic procedure in selected patients with RC and synchronous metastases, offering the patients the longest pelvic symptom-free periods.
Full text:
1
Database:
MEDLINE
Main subject:
Rectal Neoplasms
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2009
Type:
Article