Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Surg Today. 2022 Jul;52(7):1072-1080. doi: 10.1007/s00595-021-02419-x. Epub 2022 Jan 8.
Rectal cancers pose a threat to the mesorectal fascia or invade neighboring structures or organs. Some tumors are potentially resectable but are likely to be positive at the resection margin for cancer involvement and are thus recognized as "borderline resectable (BR)" tumors. This study aimed to clarify the short- and long-term outcomes of neoadjuvant chemoradiotherapy (nCRT) for BR low rectal cancer at a single Japanese center.
Data of 55 patients, who received nCRT followed by BR low rectal cancer surgery between April 2010 and December 2019, were evaluated for the short-term outcomes. The oncological outcomes of 42 patients who underwent surgery between April 2010 and December 2018 were evaluated.
Thirty-six (65.5%) patients had cT4 tumors, and 53 (96.4%) patients had a clinical-stage III or IV. Lateral lymph node dissection was performed in 42 (76.4%) patients. The incidence of severe post-operative complications (Clavien-Dindo grade ≥ III) was 18.2%. Fifty-two (94.5%) patients had a pathological negative resection margin. The 3-year overall survival rate, disease-free survival rate, and cumulative incidence of local recurrence were 100%, 70.3%, and 5.3%, respectively.
The short- and long-term outcomes of nCRT for BR low rectal cancer were acceptable. In particular, reasonable local control was achieved.
直肠癌可侵犯直肠系膜筋膜或邻近结构或器官。有些肿瘤具有潜在的可切除性，但可能在肿瘤切除边缘存在癌症累及，因此被认为是“边界可切除（BR）”肿瘤。本研究旨在阐明单中心日本患者接受新辅助放化疗（nCRT）治疗 BR 低位直肠癌的短期和长期结果。
评估了 2010 年 4 月至 2019 年 12 月期间接受 nCRT 联合 BR 低位直肠癌手术的 55 例患者的短期结果。评估了 2010 年 4 月至 2018 年 12 月期间接受手术的 42 例患者的肿瘤学结果。
36 例（65.5%）患者为 cT4 肿瘤，53 例（96.4%）患者为临床 III 或 IV 期。42 例（76.4%）患者行侧方淋巴结清扫术。严重术后并发症（Clavien-Dindo 分级≥III 级）发生率为 18.2%。52 例（94.5%）患者的病理切缘阴性。3 年总生存率、无病生存率和局部复发累积发生率分别为 100%、70.3%和 5.3%。
nCRT 治疗 BR 低位直肠癌的短期和长期结果是可以接受的。特别是实现了合理的局部控制。
