LOW LOCAL RECURRENCE RATES AFTER RECTAL CANCER RESECTION WITH LIMITED USE OF PREOPERATIVE RADIOTHERAPY

Background: Local recurrence rates after curative rectal resection for rectal cancer have decreased after introduction of TME. In order to achieve even further reduction in local recurrence rates, several hospitals increase the use of preoperative radiotherapy. Thus, radiotherapy-related side effects will increase. The aim of the study was to evaluate the results of the TME-technique with minimal use of radiotherapy. Materials and Methods: A prospective observational. study from 1993 to 2000 of 137 consecutive patients treated for rectal cancer at the Department of Surgery, Nordland Hospital HF, Bodo, Norway. Results: 115 patients underwent curative resections (84%). Eight patients (6.4 %) received peri-operative radiotherapy: three preoperatively (2.4%) because of clinically fixed tumours and five patients (4%) postoperatively; four with pR1-resections and one patient after perforation of the rectum. The local recurrence rate was 3.4 % with an observation time of 5 years. The total survival rate was 74% in curative group. In 22 patients the treatment was palliative. Only one of these patient survived 5 years. Conclusion: With TME-technique it is possible to achieve low recurrence rates and high survival rates with a high curative rate with minimal use of additional radiotherapy.