P-0282 - Impact of the radio chemotherapy in the control local of the cancers locally advances of the rectum

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Haoui Messaouda
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors H. Messaouda, N. Aksil, K. Boualga
  • Centre Anticancer, Blida/DZ

Abstract

Introduction

Estimate the impact of the radio chemotherapy in the control local and metastases of the cancer locally evolved rectum.

Methods

Between 2009 and 2010, 52 patients had a cancer of the rectum. 16 men and 26 women, the sex-ratio is 1.6, the median age was 48 years (19-69 years). 49 patients had an ADK Liberkhunien. 3 patients had ADK colloide. 39 cases of low rectum (75%). 13 cases of the mean rectum (25%). Stage II 15 patients (28%). Stage III = 37 (72%) among them more of 15 cases of T4N1, N2. All the patients had radiotherapy with 45 GY and 3 to 4 curies of FOLFOX4.

Results

47 patients were operated (91%) and 4 patients were not operated (1 case had a lung metastasis before surgery, 3 cases the tumor was fixed). The surgery was: TME with perineal abdominal amputation 21patients (43%). 13 Patients had TME + anastomose colorectale (27%). 12 patients had TME +anastomose coloanale (25%) and 2 patients had a local resection (4%). The classification after surgery was: YpT0N0 4 patients (8%). YpT0N1N2 2 patients 4% ypT0N0M1 (metastasis per-op) 1 patient. (7 complete response of the tumor (14%)). Stage I (ypT1T2N0) 10 = 21%. Stage IIA =13 patients= 27%. Stage IIB =12 (25%) stage IIIA, stage IIIB (10% 20%) 2 patientes had a local resection 1 patient had a RIS with a complete answer 1 patient died during the surgery. We remark a downstaging and a downsizing of the tumor after the RTCT associated with surgery objective answer is superior than 70% (34 patients), 4 patients had hepatic metastases-discovered during the surgery with a good tumor answer. 46 patients had a negative margin (RO), and 1 patient had marge circonferentiel infiltrad. 45 patients had an adjuvant chemotherapy. A relapse at 13 months after surgery was 2% (the patient who was R1). The distance relapses in 13 patients (27%)= 6 lung metastases, 4 patients a liver metastases, 3 carcinoses. The deadline of appearance of the metastases was at 8 months (3-18 months) 41 patients are in survival, the average survival is of 35 months.

Conclusion

The radiochemotherapy has a significant impact on the control local (14% complete answer, 2% local relapse at 13 months), the sphinctérienne conservation in 32% patients with of the cancer of low rectum (under 5cm of the anal margin) had a preservative treatment. The reduction of the rate of the remote relapses requires a good pre-therapeutic radiology, a more effective chemotherapy with the addition of the other molecules, to discuss a possible CT néoadjuvante in CPR for stages very evolved locally, and respect for the deadlines of the treatment.