RECTAL CA - VAKALIS . X

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  1. 1. Rectal CancerSurgery is the mainstay of treatment of RC After surgical resection, local failure is common Local recurrence after conventional surgery: 15%-65% (average of 28%)
  2. 2. T1 T2 T3 T4 N+5 , 10% 15-35% 20-45% >50% 40-65%McCall J, et al. Int J Colorectal Dis 1995 10. 126-132 Bokey EL, et al. BJS 1999; 86:1164. Shirouzu et al., Am J. Surg 1993; 165:233
  3. 3. Number of pts.GITSG NCCTG 202 204NSABP-R01 555Surgery alone LF (%)2425S (%) Radiotherapy LF (%) S (%) Chemotherapy LF (%) S (%) Chemoradioth. LF (%) S (%)43 20 52 27 21 11 5943 16 41 21 53 8 5825 4714
  4. 4. : 1980s2000s 35Local failure (%)30Norway GITSG-2 Dutch-TMENSABP-R01 INT-0114 UlsanGITSG-1 NSABP-R02 CAO/ARO/AIOMayo-NCCTG INT-PVI25 20 1510 5 0 sx onlysx RTsx CTRTTME + RT/CTRT
  5. 5. Ca +( + ) : 40%