Complications After Sphincter-Saving Resection in Rectal Cancer Patients According to Whether Chemoradiotherapy Is Performed Before or After Surgery
Purpose The aim of the present study was to compare the influence of preoperative chemoradiotherapy (CRT) with postoperative CRT on the incidence and types of postoperative complications in rectal cancer patients who underwent sphincter-saving resection. Patients and Methods We reviewed 285 patients...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2010-09, Vol.78 (1), p.156-163 |
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| creator | Kim, Chan Wook, M.D Kim, Jong Hoon, M.D Yu, Chang Sik, M.D Shin, Ui Sup, M.D Park, Jin Seok, M.D Jung, Kwang Yong, M.D Kim, Tae Won, M.D Yoon, Sang Nam, M.D Lim, Seok-Byung, M.D Kim, Jin Cheon, M.D |
| description | Purpose The aim of the present study was to compare the influence of preoperative chemoradiotherapy (CRT) with postoperative CRT on the incidence and types of postoperative complications in rectal cancer patients who underwent sphincter-saving resection. Patients and Methods We reviewed 285 patients who received preoperative CRT and 418 patients who received postoperative CRT between January 2000 and December 2006. Results There was no between-group difference in age, gender, or cancer stage. In the pre-CRT group, the mean level of anastomosis from the anal verge was lower (3.5 ± 1.4 cm vs. 4.3 ± 1.7 cm, p < 0.001) and the rate of T4 lesion and temporary diverting ileostomy was higher than in the post-CRT group. Delayed anastomotic leakage and rectovaginal fistulae developed more frequently in the pre-CRT group than in the post-CRT group (3.9% vs. 1.2%, p = 0.020, 6.5% vs. 1.3%, p = 0.027, respectively). Small bowel obstruction (arising from radiation enteritis) requiring surgical intervention was more frequent in the post-CRT group (0% in the pre-CRT group vs. 1.4% in the post-CRT group, p = 0.042). Multivariate analysis identified preoperative CRT as an independent risk factor for fistulous complications (delayed anastomotic leakage, rectovaginal fistula, rectovesical fistula), and postoperative CRT as a risk factor for obstructive complications (anastomotic stricture, small bowel obstruction). The stoma-free rates were significantly lower in the pre-CRT group than in the post-CRT group (5-year stoma-free rates: 92.8% vs. 97.0%, p = 0.008). Conclusion The overall postoperative complication rates were similar between the pre-CRT and the Post-CRT groups. However, the pattern of postoperative complications seen after sphincter- saving resection differed with reference to the timing of CRT. |
| doi_str_mv | 10.1016/j.ijrobp.2009.07.1684 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_21436155</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0360301609027801</els_id><sourcerecordid>748976236</sourcerecordid><originalsourceid>FETCH-LOGICAL-c477t-59dd8640d15b013fb096a6bfa804b46e43027fa66c089ba086e41542bef2ca273</originalsourceid><addsrcrecordid>eNqFks2O1DAMxysEYoeFRwBVQohTB6dNk_YCWkZ8rLQSKwYEtyhN3Z0MnaQknZXmPXhgHM0sSFw4xU5-tmP_nWVPGSwZMPFqu7Tb4LtpWQK0S5BLJhp-L1uwRrZFVdff72cLqAQUFdFn2aMYtwDAmOQPs7MSGAgBfJH9WvndNFqjZ-tdzC-GGUO-njbWGbKKtb617ib_jBFNInLryDGzHvOVdobYa4pEN1OoMT70iZ59_m2D84ZeVxvc-aB765Orp0N-GfNrDIMPO-zzt0gG5j7cFd6HGwyHx9mDQY8Rn5zO8-zr-3dfVh-Lq08fLlcXV4XhUs5F3fZ9Izj0rO6AVUMHrdCiG3QDvOMCeQWlHLQQBpq209DQFat52eFQGl3K6jx7fszr42xVNHZGszHeOepQlYxXgtU1US-P1BT8zz3GWe1sNDiO2qHfRyV500pRVoLI-kia4GMMOKgp2J0OB8VAJdXUVh1VU0k1BVIl1Sju2anCvqOx_Im6k4mAFydAR6PHIdDsbfzLVayWFU8NvTlySFO7tRhSU0g69Taknnpv__uV1_9kMKN1tB_jDzxg3Pp9cCSJYiqWCtQ6rVjaMGhp1g2p8BvZHc38</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>748976236</pqid></control><display><type>article</type><title>Complications After Sphincter-Saving Resection in Rectal Cancer Patients According to Whether Chemoradiotherapy Is Performed Before or After Surgery</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Collection</source><creator>Kim, Chan Wook, M.D ; Kim, Jong Hoon, M.D ; Yu, Chang Sik, M.D ; Shin, Ui Sup, M.D ; Park, Jin Seok, M.D ; Jung, Kwang Yong, M.D ; Kim, Tae Won, M.D ; Yoon, Sang Nam, M.D ; Lim, Seok-Byung, M.D ; Kim, Jin Cheon, M.D</creator><creatorcontrib>Kim, Chan Wook, M.D ; Kim, Jong Hoon, M.D ; Yu, Chang Sik, M.D ; Shin, Ui Sup, M.D ; Park, Jin Seok, M.D ; Jung, Kwang Yong, M.D ; Kim, Tae Won, M.D ; Yoon, Sang Nam, M.D ; Lim, Seok-Byung, M.D ; Kim, Jin Cheon, M.D</creatorcontrib><description>Purpose The aim of the present study was to compare the influence of preoperative chemoradiotherapy (CRT) with postoperative CRT on the incidence and types of postoperative complications in rectal cancer patients who underwent sphincter-saving resection. Patients and Methods We reviewed 285 patients who received preoperative CRT and 418 patients who received postoperative CRT between January 2000 and December 2006. Results There was no between-group difference in age, gender, or cancer stage. In the pre-CRT group, the mean level of anastomosis from the anal verge was lower (3.5 ± 1.4 cm vs. 4.3 ± 1.7 cm, p < 0.001) and the rate of T4 lesion and temporary diverting ileostomy was higher than in the post-CRT group. Delayed anastomotic leakage and rectovaginal fistulae developed more frequently in the pre-CRT group than in the post-CRT group (3.9% vs. 1.2%, p = 0.020, 6.5% vs. 1.3%, p = 0.027, respectively). Small bowel obstruction (arising from radiation enteritis) requiring surgical intervention was more frequent in the post-CRT group (0% in the pre-CRT group vs. 1.4% in the post-CRT group, p = 0.042). Multivariate analysis identified preoperative CRT as an independent risk factor for fistulous complications (delayed anastomotic leakage, rectovaginal fistula, rectovesical fistula), and postoperative CRT as a risk factor for obstructive complications (anastomotic stricture, small bowel obstruction). The stoma-free rates were significantly lower in the pre-CRT group than in the post-CRT group (5-year stoma-free rates: 92.8% vs. 97.0%, p = 0.008). Conclusion The overall postoperative complication rates were similar between the pre-CRT and the Post-CRT groups. However, the pattern of postoperative complications seen after sphincter- saving resection differed with reference to the timing of CRT.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2009.07.1684</identifier><identifier>PMID: 20106604</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Adenocarcinoma - drug therapy ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Adenocarcinoma - surgery ; Adult ; Aged ; Anal Canal - surgery ; Anastomosis, Surgical ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; BODY ; Capecitabine ; COMBINED THERAPY ; Complications ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; DIGESTIVE SYSTEM ; DISEASES ; Drug Administration Schedule ; Enteritis - etiology ; Enteritis - surgery ; Female ; Fluorouracil - administration & dosage ; Fluorouracil - analogs & derivatives ; Gastroenterology. Liver. Pancreas. Abdomen ; GASTROINTESTINAL TRACT ; Hematology, Oncology and Palliative Medicine ; Humans ; Ileostomy - statistics & numerical data ; Intestinal Obstruction - etiology ; Intestinal Obstruction - surgery ; INTESTINES ; Korea ; LARGE INTESTINE ; Leucovorin - administration & dosage ; Male ; Medical sciences ; MEDICINE ; Middle Aged ; Multivariate Analysis ; Neoadjuvant Therapy - adverse effects ; Neoadjuvant Therapy - methods ; NEOPLASMS ; ORGANS ; Postoperative chemoradiotherapy ; Postoperative Complications - etiology ; Preoperative Care ; Preoperative chemoradiotherapy ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiotherapy Dosage ; Rectal cancer ; Rectal Fistula - etiology ; Rectal Fistula - surgery ; Rectal Neoplasms - drug therapy ; Rectal Neoplasms - pathology ; Rectal Neoplasms - radiotherapy ; Rectal Neoplasms - surgery ; Rectovaginal Fistula - etiology ; Rectovaginal Fistula - therapy ; RECTUM ; Rectum - surgery ; Stoma-free survival ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; SURGERY ; THERAPY ; Tumors ; Urinary Bladder Fistula - etiology ; Urinary Bladder Fistula - surgery ; Young Adult]]></subject><ispartof>International journal of radiation oncology, biology, physics, 2010-09, Vol.78 (1), p.156-163</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright (c) 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-59dd8640d15b013fb096a6bfa804b46e43027fa66c089ba086e41542bef2ca273</citedby><cites>FETCH-LOGICAL-c477t-59dd8640d15b013fb096a6bfa804b46e43027fa66c089ba086e41542bef2ca273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301609027801$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23157347$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20106604$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21436155$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Chan Wook, M.D</creatorcontrib><creatorcontrib>Kim, Jong Hoon, M.D</creatorcontrib><creatorcontrib>Yu, Chang Sik, M.D</creatorcontrib><creatorcontrib>Shin, Ui Sup, M.D</creatorcontrib><creatorcontrib>Park, Jin Seok, M.D</creatorcontrib><creatorcontrib>Jung, Kwang Yong, M.D</creatorcontrib><creatorcontrib>Kim, Tae Won, M.D</creatorcontrib><creatorcontrib>Yoon, Sang Nam, M.D</creatorcontrib><creatorcontrib>Lim, Seok-Byung, M.D</creatorcontrib><creatorcontrib>Kim, Jin Cheon, M.D</creatorcontrib><title>Complications After Sphincter-Saving Resection in Rectal Cancer Patients According to Whether Chemoradiotherapy Is Performed Before or After Surgery</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose The aim of the present study was to compare the influence of preoperative chemoradiotherapy (CRT) with postoperative CRT on the incidence and types of postoperative complications in rectal cancer patients who underwent sphincter-saving resection. Patients and Methods We reviewed 285 patients who received preoperative CRT and 418 patients who received postoperative CRT between January 2000 and December 2006. Results There was no between-group difference in age, gender, or cancer stage. In the pre-CRT group, the mean level of anastomosis from the anal verge was lower (3.5 ± 1.4 cm vs. 4.3 ± 1.7 cm, p < 0.001) and the rate of T4 lesion and temporary diverting ileostomy was higher than in the post-CRT group. Delayed anastomotic leakage and rectovaginal fistulae developed more frequently in the pre-CRT group than in the post-CRT group (3.9% vs. 1.2%, p = 0.020, 6.5% vs. 1.3%, p = 0.027, respectively). Small bowel obstruction (arising from radiation enteritis) requiring surgical intervention was more frequent in the post-CRT group (0% in the pre-CRT group vs. 1.4% in the post-CRT group, p = 0.042). Multivariate analysis identified preoperative CRT as an independent risk factor for fistulous complications (delayed anastomotic leakage, rectovaginal fistula, rectovesical fistula), and postoperative CRT as a risk factor for obstructive complications (anastomotic stricture, small bowel obstruction). The stoma-free rates were significantly lower in the pre-CRT group than in the post-CRT group (5-year stoma-free rates: 92.8% vs. 97.0%, p = 0.008). Conclusion The overall postoperative complication rates were similar between the pre-CRT and the Post-CRT groups. However, the pattern of postoperative complications seen after sphincter- saving resection differed with reference to the timing of CRT.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Anal Canal - surgery</subject><subject>Anastomosis, Surgical</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>BODY</subject><subject>Capecitabine</subject><subject>COMBINED THERAPY</subject><subject>Complications</subject><subject>Deoxycytidine - administration & dosage</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>DIGESTIVE SYSTEM</subject><subject>DISEASES</subject><subject>Drug Administration Schedule</subject><subject>Enteritis - etiology</subject><subject>Enteritis - surgery</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Fluorouracil - analogs & derivatives</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>GASTROINTESTINAL TRACT</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Ileostomy - statistics & numerical data</subject><subject>Intestinal Obstruction - etiology</subject><subject>Intestinal Obstruction - surgery</subject><subject>INTESTINES</subject><subject>Korea</subject><subject>LARGE INTESTINE</subject><subject>Leucovorin - administration & dosage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoadjuvant Therapy - adverse effects</subject><subject>Neoadjuvant Therapy - methods</subject><subject>NEOPLASMS</subject><subject>ORGANS</subject><subject>Postoperative chemoradiotherapy</subject><subject>Postoperative Complications - etiology</subject><subject>Preoperative Care</subject><subject>Preoperative chemoradiotherapy</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiotherapy Dosage</subject><subject>Rectal cancer</subject><subject>Rectal Fistula - etiology</subject><subject>Rectal Fistula - surgery</subject><subject>Rectal Neoplasms - drug therapy</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - radiotherapy</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectovaginal Fistula - etiology</subject><subject>Rectovaginal Fistula - therapy</subject><subject>RECTUM</subject><subject>Rectum - surgery</subject><subject>Stoma-free survival</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>SURGERY</subject><subject>THERAPY</subject><subject>Tumors</subject><subject>Urinary Bladder Fistula - etiology</subject><subject>Urinary Bladder Fistula - surgery</subject><subject>Young Adult</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks2O1DAMxysEYoeFRwBVQohTB6dNk_YCWkZ8rLQSKwYEtyhN3Z0MnaQknZXmPXhgHM0sSFw4xU5-tmP_nWVPGSwZMPFqu7Tb4LtpWQK0S5BLJhp-L1uwRrZFVdff72cLqAQUFdFn2aMYtwDAmOQPs7MSGAgBfJH9WvndNFqjZ-tdzC-GGUO-njbWGbKKtb617ib_jBFNInLryDGzHvOVdobYa4pEN1OoMT70iZ59_m2D84ZeVxvc-aB765Orp0N-GfNrDIMPO-zzt0gG5j7cFd6HGwyHx9mDQY8Rn5zO8-zr-3dfVh-Lq08fLlcXV4XhUs5F3fZ9Izj0rO6AVUMHrdCiG3QDvOMCeQWlHLQQBpq209DQFat52eFQGl3K6jx7fszr42xVNHZGszHeOepQlYxXgtU1US-P1BT8zz3GWe1sNDiO2qHfRyV500pRVoLI-kia4GMMOKgp2J0OB8VAJdXUVh1VU0k1BVIl1Sju2anCvqOx_Im6k4mAFydAR6PHIdDsbfzLVayWFU8NvTlySFO7tRhSU0g69Taknnpv__uV1_9kMKN1tB_jDzxg3Pp9cCSJYiqWCtQ6rVjaMGhp1g2p8BvZHc38</recordid><startdate>20100901</startdate><enddate>20100901</enddate><creator>Kim, Chan Wook, M.D</creator><creator>Kim, Jong Hoon, M.D</creator><creator>Yu, Chang Sik, M.D</creator><creator>Shin, Ui Sup, M.D</creator><creator>Park, Jin Seok, M.D</creator><creator>Jung, Kwang Yong, M.D</creator><creator>Kim, Tae Won, M.D</creator><creator>Yoon, Sang Nam, M.D</creator><creator>Lim, Seok-Byung, M.D</creator><creator>Kim, Jin Cheon, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20100901</creationdate><title>Complications After Sphincter-Saving Resection in Rectal Cancer Patients According to Whether Chemoradiotherapy Is Performed Before or After Surgery</title><author>Kim, Chan Wook, M.D ; Kim, Jong Hoon, M.D ; Yu, Chang Sik, M.D ; Shin, Ui Sup, M.D ; Park, Jin Seok, M.D ; Jung, Kwang Yong, M.D ; Kim, Tae Won, M.D ; Yoon, Sang Nam, M.D ; Lim, Seok-Byung, M.D ; Kim, Jin Cheon, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-59dd8640d15b013fb096a6bfa804b46e43027fa66c089ba086e41542bef2ca273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Anal Canal - surgery</topic><topic>Anastomosis, Surgical</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>BODY</topic><topic>Capecitabine</topic><topic>COMBINED THERAPY</topic><topic>Complications</topic><topic>Deoxycytidine - administration & dosage</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>DIGESTIVE SYSTEM</topic><topic>DISEASES</topic><topic>Drug Administration Schedule</topic><topic>Enteritis - etiology</topic><topic>Enteritis - surgery</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Fluorouracil - analogs & derivatives</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>GASTROINTESTINAL TRACT</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Ileostomy - statistics & numerical data</topic><topic>Intestinal Obstruction - etiology</topic><topic>Intestinal Obstruction - surgery</topic><topic>INTESTINES</topic><topic>Korea</topic><topic>LARGE INTESTINE</topic><topic>Leucovorin - administration & dosage</topic><topic>Male</topic><topic>Medical sciences</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoadjuvant Therapy - adverse effects</topic><topic>Neoadjuvant Therapy - methods</topic><topic>NEOPLASMS</topic><topic>ORGANS</topic><topic>Postoperative chemoradiotherapy</topic><topic>Postoperative Complications - etiology</topic><topic>Preoperative Care</topic><topic>Preoperative chemoradiotherapy</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiotherapy Dosage</topic><topic>Rectal cancer</topic><topic>Rectal Fistula - etiology</topic><topic>Rectal Fistula - surgery</topic><topic>Rectal Neoplasms - drug therapy</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - radiotherapy</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectovaginal Fistula - etiology</topic><topic>Rectovaginal Fistula - therapy</topic><topic>RECTUM</topic><topic>Rectum - surgery</topic><topic>Stoma-free survival</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>SURGERY</topic><topic>THERAPY</topic><topic>Tumors</topic><topic>Urinary Bladder Fistula - etiology</topic><topic>Urinary Bladder Fistula - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Chan Wook, M.D</creatorcontrib><creatorcontrib>Kim, Jong Hoon, M.D</creatorcontrib><creatorcontrib>Yu, Chang Sik, M.D</creatorcontrib><creatorcontrib>Shin, Ui Sup, M.D</creatorcontrib><creatorcontrib>Park, Jin Seok, M.D</creatorcontrib><creatorcontrib>Jung, Kwang Yong, M.D</creatorcontrib><creatorcontrib>Kim, Tae Won, M.D</creatorcontrib><creatorcontrib>Yoon, Sang Nam, M.D</creatorcontrib><creatorcontrib>Lim, Seok-Byung, M.D</creatorcontrib><creatorcontrib>Kim, Jin Cheon, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Chan Wook, M.D</au><au>Kim, Jong Hoon, M.D</au><au>Yu, Chang Sik, M.D</au><au>Shin, Ui Sup, M.D</au><au>Park, Jin Seok, M.D</au><au>Jung, Kwang Yong, M.D</au><au>Kim, Tae Won, M.D</au><au>Yoon, Sang Nam, M.D</au><au>Lim, Seok-Byung, M.D</au><au>Kim, Jin Cheon, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complications After Sphincter-Saving Resection in Rectal Cancer Patients According to Whether Chemoradiotherapy Is Performed Before or After Surgery</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2010-09-01</date><risdate>2010</risdate><volume>78</volume><issue>1</issue><spage>156</spage><epage>163</epage><pages>156-163</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose The aim of the present study was to compare the influence of preoperative chemoradiotherapy (CRT) with postoperative CRT on the incidence and types of postoperative complications in rectal cancer patients who underwent sphincter-saving resection. Patients and Methods We reviewed 285 patients who received preoperative CRT and 418 patients who received postoperative CRT between January 2000 and December 2006. Results There was no between-group difference in age, gender, or cancer stage. In the pre-CRT group, the mean level of anastomosis from the anal verge was lower (3.5 ± 1.4 cm vs. 4.3 ± 1.7 cm, p < 0.001) and the rate of T4 lesion and temporary diverting ileostomy was higher than in the post-CRT group. Delayed anastomotic leakage and rectovaginal fistulae developed more frequently in the pre-CRT group than in the post-CRT group (3.9% vs. 1.2%, p = 0.020, 6.5% vs. 1.3%, p = 0.027, respectively). Small bowel obstruction (arising from radiation enteritis) requiring surgical intervention was more frequent in the post-CRT group (0% in the pre-CRT group vs. 1.4% in the post-CRT group, p = 0.042). Multivariate analysis identified preoperative CRT as an independent risk factor for fistulous complications (delayed anastomotic leakage, rectovaginal fistula, rectovesical fistula), and postoperative CRT as a risk factor for obstructive complications (anastomotic stricture, small bowel obstruction). The stoma-free rates were significantly lower in the pre-CRT group than in the post-CRT group (5-year stoma-free rates: 92.8% vs. 97.0%, p = 0.008). Conclusion The overall postoperative complication rates were similar between the pre-CRT and the Post-CRT groups. However, the pattern of postoperative complications seen after sphincter- saving resection differed with reference to the timing of CRT.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20106604</pmid><doi>10.1016/j.ijrobp.2009.07.1684</doi><tpages>8</tpages></addata></record> |
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| recordid | cdi_osti_scitechconnect_21436155 |
| source | MEDLINE; Elsevier ScienceDirect Journals Collection |
| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - pathology Adenocarcinoma - radiotherapy Adenocarcinoma - surgery Adult Aged Anal Canal - surgery Anastomosis, Surgical Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences BODY Capecitabine COMBINED THERAPY Complications Deoxycytidine - administration & dosage Deoxycytidine - analogs & derivatives DIGESTIVE SYSTEM DISEASES Drug Administration Schedule Enteritis - etiology Enteritis - surgery Female Fluorouracil - administration & dosage Fluorouracil - analogs & derivatives Gastroenterology. Liver. Pancreas. Abdomen GASTROINTESTINAL TRACT Hematology, Oncology and Palliative Medicine Humans Ileostomy - statistics & numerical data Intestinal Obstruction - etiology Intestinal Obstruction - surgery INTESTINES Korea LARGE INTESTINE Leucovorin - administration & dosage Male Medical sciences MEDICINE Middle Aged Multivariate Analysis Neoadjuvant Therapy - adverse effects Neoadjuvant Therapy - methods NEOPLASMS ORGANS Postoperative chemoradiotherapy Postoperative Complications - etiology Preoperative Care Preoperative chemoradiotherapy Radiology RADIOLOGY AND NUCLEAR MEDICINE Radiotherapy Dosage Rectal cancer Rectal Fistula - etiology Rectal Fistula - surgery Rectal Neoplasms - drug therapy Rectal Neoplasms - pathology Rectal Neoplasms - radiotherapy Rectal Neoplasms - surgery Rectovaginal Fistula - etiology Rectovaginal Fistula - therapy RECTUM Rectum - surgery Stoma-free survival Stomach. Duodenum. Small intestine. Colon. Rectum. Anus SURGERY THERAPY Tumors Urinary Bladder Fistula - etiology Urinary Bladder Fistula - surgery Young Adult |
| title | Complications After Sphincter-Saving Resection in Rectal Cancer Patients According to Whether Chemoradiotherapy Is Performed Before or After Surgery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T15%3A05%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_osti_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Complications%20After%20Sphincter-Saving%20Resection%20in%20Rectal%20Cancer%20Patients%20According%20to%20Whether%20Chemoradiotherapy%20Is%20Performed%20Before%20or%20After%20Surgery&rft.jtitle=International%20journal%20of%20radiation%20oncology,%20biology,%20physics&rft.au=Kim,%20Chan%20Wook,%20M.D&rft.date=2010-09-01&rft.volume=78&rft.issue=1&rft.spage=156&rft.epage=163&rft.pages=156-163&rft.issn=0360-3016&rft.eissn=1879-355X&rft.coden=IOBPD3&rft_id=info:doi/10.1016/j.ijrobp.2009.07.1684&rft_dat=%3Cproquest_osti_%3E748976236%3C/proquest_osti_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=748976236&rft_id=info:pmid/20106604&rft_els_id=S0360301609027801&rfr_iscdi=true |