OUTCOME OF POSTOPERATIVE ADJUVANT TREATMENT AND PROGNOSTIC FACTORS IN RECTAL CANCER

Postoperative adjuvant therapy significantly improves disease free and overall survival in rectal cancer. We retrospectively analyzed treatment outcome of 88 patients with pathological stage II and III rectal cancer treated at our institution between 1989-1995 and evaluated prognostic factors for disease-free and overall survival. All patients received radiotherapy and 39 also received adjuvant chemotherapy after radiotherapy. The median total dose of radiotherapy was 5040 cGy. Chemotherapy was fluorouracil based, the most frequent regimen being 5-fluorouracil and folinic acid. Age, gender, T and N stage, type of operation, histopathologic differentation, distance from anal canal, adjuvant treatment modality, and stage were tested as prognostic factors. The median follow-up was 36 months (range 6-100). The local failure and the distance metastases rates were 24% and 22%, respectively. Disease free and overall survival at 5 years were 52% (SE: 6.9%) and 53% (SE: 6.0%), respectively. No independent prognostic factor for disease free survival was identified; only the N stage approached borderline significance (P=0.098). N stage proved to be an independent prognostic factor for overall survival by multivariate analysis (P=0.033). Distance from anal canal was the only other factor of borderline significance (P=0.069).