PMID- 31788805
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230201
IS  - 1096-9098 (Electronic)
IS  - 0022-4790 (Linking)
VI  - 121
IP  - 2
DP  - 2020 Feb
TI  - Organ-saving surgery for rectal cancer after neoadjuvant chemoradiation: Analysis 
      of failures and long-term results.
PG  - 375-381
LID - 10.1002/jso.25794 [doi]
AB  - BACKGROUND: To analyze long-term results and risk of relapse in the clinical TNM 
      stages II and III, mid-low rectal cancer patients (RC pts), treated with 
      transanal local excision (LE) after major response to neoadjuvant chemoradiation 
      (n-CRT). METHODS: Thirty-two out of 345 extraperitoneal cT3-4 or N+ RC pts (9.3%) 
      underwent LE. INCLUSION CRITERIA: extraperitoneal RC, adenocarcinoma, ECOG 
      Performance Status </=2. Pts with distant metastases were excluded. RESULTS: All 
      pts showed histologically clear margins of resection and 81.2% were restaged 
      ypT0/mic/1. Nine out of 32 (28.1%) pts relapsed: 7 (21.8%) showed a local 
      recurrence, of which 5 (15.6%) at the endorectal suture, 1 (3.1%) pelvic and 1 
      (3.1%) mesorectal. Two pts (6.2%) relapsed distantly. Among the pT0/1, 11.5% 
      relapsed vs 100% of the pT2 and pT4 ones. The six pts relapsing locally or in the 
      mesorectal fat underwent a salvage total mesorectal excision surgery. The old 
      patient with pelvic recurrence relapsed after 108 months and underwent a 
      re-irradiation; the two pts with distant metastases were treated with 
      chemotherapy followed by radical surgery. CONCLUSIONS: Presently combined 
      approach seems a valid option in major responders, confirming its potential 
      curative impact in the ypT0/mic/1 pts. A strict selection of pts is basic to 
      obtain favourable results.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Cosimelli, Maurizio
AU  - Cosimelli M
AD  - Colorectal Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, 
      Italy.
FAU - Ursi, Pietro
AU  - Ursi P
AD  - Department of General Surgery and Surgical Specialties "Paride Stefanini", 
      Sapienza University of Rome, Rome, Italy.
FAU - Mancini, Raffaello
AU  - Mancini R
AD  - Robotic General Surgery Unit, San Giovanni Addolorata Hospital, Rome, Italy.
FAU - Pattaro, Giada
AU  - Pattaro G
AD  - Department of General Surgery, S.M. Goretti Hospital, Latina, Italy.
FAU - Perri, Pasquale
AU  - Perri P
AD  - Division of General and HepatoPancreatoBiliary Surgery, IRCCS Regina Elena 
      National Cancer Institute, Rome, Italy.
FAU - Parrino, Chiara
AU  - Parrino C
AD  - Division of General and HepatoPancreatoBiliary Surgery, IRCCS Regina Elena 
      National Cancer Institute, Rome, Italy.
FAU - De Peppo, Valerio
AU  - De Peppo V
AD  - Division of General and HepatoPancreatoBiliary Surgery, IRCCS Regina Elena 
      National Cancer Institute, Rome, Italy.
FAU - Diodoro, Maria Grazia
AU  - Diodoro MG
AD  - Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, 
      Italy.
FAU - Balla, Andrea
AU  - Balla A
AUID- ORCID: 0000-0002-0182-8761
AD  - Department of General Surgery and Surgical Specialties "Paride Stefanini", 
      Sapienza University of Rome, Rome, Italy.
FAU - Grazi, Gian Luca
AU  - Grazi GL
AD  - Division of General and HepatoPancreatoBiliary Surgery, IRCCS Regina Elena 
      National Cancer Institute, Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20191201
PL  - United States
TA  - J Surg Oncol
JT  - Journal of surgical oncology
JID - 0222643
SB  - IM
OTO - NOTNLM
OT  - neoadjuvant chemoradiation
OT  - organ-saving surgery
OT  - rectal cancer
OT  - transanal local excision
EDAT- 2019/12/04 06:00
MHDA- 2019/12/04 06:01
CRDT- 2019/12/03 06:00
PHST- 2019/10/30 00:00 [received]
PHST- 2019/11/25 00:00 [accepted]
PHST- 2019/12/04 06:00 [pubmed]
PHST- 2019/12/04 06:01 [medline]
PHST- 2019/12/03 06:00 [entrez]
AID - 10.1002/jso.25794 [doi]
PST - ppublish
SO  - J Surg Oncol. 2020 Feb;121(2):375-381. doi: 10.1002/jso.25794. Epub 2019 Dec 1.