Source: Colorectal Disease; Oct 2017; vol. 19 ; p. 37
Publication Date: Oct 2017
Publication Type(s): Conference Abstract
Available at Colorectal Disease - from Wiley Online Library Medicine and Nursing Collection 2018 - NHS
Abstract:Purpose: The management of locally advanced rectal tumours involves pre-operative long course chemo-radiotherapy, followed by resectional surgery. The aim of this study was to report the outcomes for patients with rectal cancer who fail to achieve a clinical complete response following this chemo-radiotherapy. Methods: This was a prospective cohort study of a consecutive series of a single surgeon (DAE). The study included 32 patients with rectal cancer who failed to achieve a clinical complete response presenting between October 2010 and February 2016. Demographics, performance status, pathology and clinical outcomes were recorded prospectively. Results: There were 32 patients (25 men and 7 women). The median age was 64 (IQR 39-78). Twenty-six patients underwent resectional surgery; three refused surgery. The thirty-day mortality rate was zero. Intra-operative tumour perforation occurred in one case. The permanent stoma rate was 75% (24/32). Six patients had a positive CRM (18%) and eight (25%) developed a local recurrence. Median follow- up was 37 months, during which time five patients died. Conclusions: Outcomes for patients who do not achieve a complete response are poor in terms of permanent stoma rate and positive margin. The extra delay introduced by the "wait and watch" programme may be a contributory factor.