Restaging abdominopelvic computed tomography before surgery after preoperative chemoradiotherapy in patients with locally advanced rectal cancer
Menée en Corée du Sud à partir de données portant sur 294 hommes (âge moyen : 62,5 ans) et 155 femmes (âge moyen : 61,8 ans) atteints d'un cancer rectal de stade localement avancé et ayant reçu une chimioradiothérapie néo-adjuvante, cette étude évalue, du point de vue de l'amélioration de la survie sans récidive, l'intérêt de réaliser, avant l'intervention chirurgicale et à l'aide d'une tomographie numérique, une seconde stadification abdomino-pelvienne de la maladie
Chemoradiotherapy (CRT) before surgery is a standard treatment for locally advanced cancer in the mid or low rectum. Long-course CRT delays surgery for several months, which may introduce a possibility, albeit small, for the tumor to make systemic progression or for occult metastasis to grow and manifest. Currently, there is no consensus regarding whether restaging abdominopelvic computed tomography (CT) is necessary before surgery after long-course CRT. Several studies have investigated this issue1- 5; however, results were conflicting. Most of the studies were small.1,2,4,5 None of them compared the oncologic outcomes between patients who received and those who did not receive (as controls) the restaging CT.1- 5 This study investigated restaging abdominopelvic CT performed before surgery after CRT in patients with locally advanced rectal cancer regarding its diagnostic yield and effect on postsurgical recurrence-free survival (RFS).
JAMA Oncology , résumé, 2016