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dc.contributor.authorBalyasnikova, S
dc.contributor.authorRead, J
dc.contributor.authorTait, D
dc.contributor.authorWotherspoon, A
dc.contributor.authorSwift, I
dc.contributor.authorCunningham, D
dc.contributor.authorTekkis, P
dc.contributor.authorBrown, G
dc.date.accessioned2017-07-19T15:17:23Z
dc.date.issued2017-02
dc.identifier.citationColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2017, 19 (2), pp. 139 - 147
dc.identifier.issn1462-8910
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/723
dc.identifier.eissn1463-1318
dc.identifier.doi10.1111/codi.13477
dc.description.abstractAim The study aimed to establish the oncological outcome of patients who opted for close surveillance with or without adjuvant chemoradiotherapy rather than radical surgery after local excision (LE) of early rectal cancer.Method The Royal Marsden Hospital Rectal Cancer database was used to identify rectal cancer patients treated by primary LE from 2006 to 2015. All patients were entered in an intensive surveillance programme.Results Twenty-eight of 34 analysed patients had a high or very high risk of residual disease predicted by adverse histopathological features for which the recommendation had been radical surgery. Eighteen (52%) of the 34 had received radiotherapy following LE. Three-year disease-free survival for the 34 patients was 85% (95% CI 78.8%-91.2%) and overall survival was 100%. Twenty-two of 24 patients with a low tumour which would have required total rectal excision have so far avoided radical surgery and remain disease free at a median follow-up of 3.2 years.Conclusion The findings suggest that with modern MRI and clinical surveillance radical surgery can be avoided in patients following initial LE of a histopathologically defined high risk early rectal cancer. These findings are comparable with those obtained after major radical resection and warrant further prospective investigation as a treatment arm in larger prospective trials.
dc.formatPrint
dc.format.extent139 - 147
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/all-rights-reserved
dc.subjectRectum
dc.subjectHumans
dc.subjectAdenocarcinoma
dc.subjectRectal Neoplasms
dc.subjectMagnetic Resonance Imaging
dc.subjectNeoplasm Staging
dc.subjectDisease-Free Survival
dc.subjectDigestive System Surgical Procedures
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectChemoradiotherapy, Adjuvant
dc.subjectTransanal Endoscopic Microsurgery
dc.titleThe results of local excision with or without postoperative adjuvant chemoradiotherapy for early rectal cancer among patients choosing to avoid radical surgery.
dc.typeJournal Article
dcterms.dateAccepted2016-04-17
rioxxterms.versionofrecord10.1111/codi.13477
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2017-02
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
pubs.issue2
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume19
pubs.embargo.termsNot known
icr.researchteamMedicine (RMH Smith Cunningham)en_US
dc.contributor.icrauthorCunningham, Daviden
dc.contributor.icrauthorMarsden,en


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