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  • Title: [Postoperative radiotherapy of rectal cancer. A retrospective study within the population of the Department of Côte-d'Or].
    Author: Janoray P, Faivre J, Milan C, Horiot JC, Klepping C, Koeklin M, Ledorze C.
    Journal: Gastroenterol Clin Biol; 1983 May; 7(5):451-6. PubMed ID: 6873560.
    Abstract:
    The registry of digestive cancer set up for French department of Cote d'Or (455,727) collects all newly diagnosed cases of rectal cancers occurring among residents. It allows to study the place and the results of postoperative radiotherapy among Dukes' B and C patients. From 1976 to 1980 postoperative radiotherapy was theorically indicated in 177 patients. Ten of the 95 Dukes' B patients (10.5 p. 100) and 26 of the 82 Dukes' C patients (31.7 p. 100) were actually irradiated postoperatively (P less than 0.001). All of the studied variables (i.e. age, sex, operative procedure, number of lymph nodes containing metastases) were not statistically different between the two groups of patients. The mean size of the tumor was slightly larger in the group treated with radiotherapy. Minor reactions after radiotherapy were frequent. There were two major complications: a small bowel obstruction and a perineal abscess with chronic fistula. The probability of local recurrence was correlated with the stage of disease and the mode of treatment. Dukes' C patients showed a 5-year local recurrence rate of 30 p. 100 after surgery alone and of 0 p. 100 after surgery and postoperative radiotherapy (P less than 0.001). The corresponding 5-year local recurrence rates for Dukes' C patients were 75 p. 100 and 26 p. 100 (P less than 0.01). The risk of local recurrence increased regularly during the 4 years following surgery. The modes of treatment did not influence the risk of developing distant metastases. Survival curves were the same for patients treated with surgery only and patients treated with combined therapy. The only difference was the 5-year survival rate of Dukes' C patients: 25 p. 100 after surgery and postoperative radiotherapy and 12 p. 100 after surgery alone but the difference was not statistically significant.
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