Exploration of Treatment in Patients with T3 Rectal Cancer with EMVI

Youzhong Ke, Yuan Liu, Hao Zhang, Jiajun Hou


To explore the clinical efficacy of neoadjuvant chemoradiotherapy, combined with surgery and direct surgery in patients with stage T3 rectal cancer combined with EMVI. Method: The clinical data of patients with extragastrointestinal middle and low rectal cancer in the First Affiliated Hospital of Chongqing Medical University from January 2015 to May 2019 were retrospective reviewed, including 59 patients in the neoadjuvant treatment group (neoadjuvant chemoradiotherapy + surgical treatment) and 71 patients in the direct surgery group. Both groups underwent total rectal total membrane resection. Data and Methods:The concurrent chemotherapy regimens were all included in the XELOX regimen. The RT was performed by IMRT with D T 45 to 50.4 G y, from 1.8 to 2.0 G y each, for 25 to 28 sessions. Perioperative conditions, postoperative pathology and follow-up of the two groups were observed. Results: There was no significant difference in postoperative conditions (gastrointestinal function recovery time, postoperative drainage drainage, postoperative time of drainage removal) between the neoadjuvant treatment group and the direct surgery group (P> 0. 05); The length of postoperative hospital stay was significantly different (P <0.05); No significant operation time occurred between the neoadjuvant treatment group (264 min vs. 239 min) and the surgical group, (P> 0. 05);The amount of intraoperative bleeding (85.7ml vs.110.0 ml), the number of lymph node dissection (11 vs. 13), the lymph node positive rate (27.12% vs.43.6%) betweenthe neoadjuvant treatment group and the direct surgery group had statistical significant (P<0. 05); The 3-yearrecurrence-free survival (93.2 %) rate was higher in the neoadjuvant treatment group than in the direct surgery group (74.6 %), which was significant (P <0.05); The 3-year survival rate (98.30,% vs. 85.9 %) was significantly significant (P <0.05); There was no significant difference in the anal preservation rate (71.19% vs. 80.28%) (P> 0. 05). Conclusion: The neoadjuvant chemoradiotherapy improves the recurrence-free survival rate of locally advanced rectal cancer, and has no obvious effect on the postoperative complications rate, anal preservation rate and gastrointestinal function recovery.


Rectal Cancer; Neoadjuvant Chemoradiotherapy; EMVI; Long-Term Efficacy

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DOI: http://dx.doi.org/10.18686/aem.v12i1.352


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