Vol. 65 No. 2 (2019), ORIGINAL ARTICLES. A. PROTOCOLS OF CLINICAL RESEARCH

Vol. 65 No. 2 (2019)

THE FEASIBILITY OF COMBINED TREATMENT OF COMPLICATED LOCALLY ADVANCED AND RECURRENT RECTAL CANCER. CASE-CONTROL STUDY

ORIGINAL ARTICLES. A. PROTOCOLS OF CLINICAL RESEARCH

https://doi.org/10.37469/0507-3758-2019-65-2-263-271

Published 01.02.2019

Valeriy Ivanov⁺⁻
Sergey Gordeev⁺⁻
Zaman Mamedli⁺⁻
Sergey Tkachev⁺⁻
Dmitriy Kuzmichev⁺⁻
Aleksandr Perevoshchikov⁺⁻
Marina Chernykh⁺⁻
Yu. Suraeva⁺⁻

Valeriy Ivanov

N. N. Blokhin National Medical Research Centre of oncology

Sergey Gordeev

N. N. Blokhin National Medical Research Centre of oncology

Zaman Mamedli

N. N. Blokhin National Medical Research Centre of oncology

Sergey Tkachev

N. N. Blokhin National Medical Research Centre of oncology

Dmitriy Kuzmichev

N. N. Blokhin National Medical Research Centre of oncology

Aleksandr Perevoshchikov

N. N. Blokhin National Medical Research Centre of oncology

Marina Chernykh

radiology department of PET-Technology

Yu. Suraeva

radiology department of PET-Technology

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Keywords

RECTAL CANCER
CHEMORADIATION
RECTOVAGINAL FISTULA
RECTOVESICAL FISTULA
PARAPROCTITIS

How to Cite

Ivanov, V., Gordeev, S., Mamedli, Z., Tkachev, S., Kuzmichev, D., Perevoshchikov, A., Chernykh, M., & Suraeva, Y. (2019). THE FEASIBILITY OF COMBINED TREATMENT OF COMPLICATED LOCALLY ADVANCED AND RECURRENT RECTAL CANCER. CASE-CONTROL STUDY. Voprosy Onkologii, 65(2), 263–271. https://doi.org/10.37469/0507-3758-2019-65-2-263-271

Abstract

INTRODUCTION: The goal of the study was to assess the feasibility of combined treatment in patients with a complicated course of locally advanced and recurrent colorectal cancer.

METHODS: A case-control study was conducted. The study group included patients with locally advanced or recurrent rectal cancer complicated by external, rectovesical, rectovaginal fistulas and/or peritumoral abscesses received neoadjuvant chemoradiation (CRT). Patients without complications comparable to the study group by sex, age, ECOG status, cT value, and the nature of the tumor (primary/recurrent) treated with neoadjuvant CRT were selected in the control group. The primary end points of the study were CRT toxicity (NCI-CTC v.4.0) and postoperative complications (Clavien-Dindo). The secondary endpoints of the study were the pathologic complete response rate 2-year progression-free survival.

RESULTS: 21 patients were included in both groups. In the study group the following complications were noted: external fistula (n = 7), rectovaginal fistula (n = 6), rectovesical fistula (n = 4), paraproctitis (n = 4), peritumoral abscess (n = 13), 16 patients (76%) required additional treatment prior the CRT: preventive colostomy (n = 14), antibacterial therapy (n = 5). Grade 3 toxicity was observed in 2 (9,52%) patients and in the study group (p = 1). Postoperative mortality was not registered in both groups. Postoperative grade III and higher complications in the study group were observed in 1 (5,2%) patient and in 3 patients (15,7) in the comtrol group (p = 0.129). 19 patients underwent surgery in each group, R0-resection was achieved in 17 patients in the study group and 19 in the control group. Pathological complete response was registered in 1 (5,2%) patient in the study group and in 4 patients in the control group (21,5%) (p = 0,14). Median progression-free survival was not achieved in both groups.

CONCLUSION: the combined treatment of complicated locally advanced and recurrent rectal cancer after appropriate planning and concomitant symptomatic therapy does not increase the toxicity profile and postoperative complications rate.

https://doi.org/10.37469/0507-3758-2019-65-2-263-271

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