Study On The Efficacy Of Neoadjuvant Radiochemotherapy In The Treatment Of T3 Mid-low Rectal Cancer

Background: Local advanced rectal cancer has a high rate of local recurrence,neoadjuvant chemotherapy combined with radical surgery concept has been widely accepted.Because of the different depth of tumor invasion,there are great differences in the prognosis of T3N0 stage rectal cancer.Whether all the T3N0 rectal cancer require neoadjuvant therapy remains controversial.Through the analysis of the relevant data of T3N0 in mid-low rectal cancer,this study provide a theoretical basis for the individualized treatment in patients with mid-low T3N0 rectal cancer.Objective: 1.To investigate the impact of preoperative radiochemotherapy on operation in patients with T3N0 mid-low rectal cancer.2.To investigate the impact of preoperative radiochemotherapy on prognosis in patients with T3N0 mid-low rectal cancer.Method: 1.Clinical data of 221 patients with T3N0 mid-low rectal cancer in the Department of Colorectal Surgery at the Changhai Hospital of The Second Military Medical University from January 2011 to December 2014 were analyzed retrospectively.Count operative time,amount of bleeding,incidence of postoperative complications,hospitalization and other indicators.2.Clinical data of 174 patients with T3N0 mid-low rectal cancer in the Department of Colorectal Surgery at the Changhai Hospital of The Second Military Medical University from January 2007 to December 2010 were analyzed retrospectively.Count local recurrence rate and overall survival rate of 5 years.Results: 1.There were significant differences in phincter preserving rate between the two groups(P=0.041).There was no significant difference in the operative time,amount of bleeding,incidence of postoperative complications and hospitalization between the two groups(P>0.05).2.There were significant differences in local recurrence rate in T3b-c N0 stage between the two groups(P=0.037).There was no significant difference in local recurrence rate in T3 a N0 stage between the two groups.There were significant differences in disease-free survival rate of 5 years in T3b-c N0 stage between the two groups(P=0.043).There was no significant difference in disease-free survival rate of 5 years in T3N0 and T3 a N0 stage between the two groups.Conclusion: 1.The rate of sphincter preservation was significantly increased in patients with stage T3N0 rectal cancer after neoadjuvant chemotherapy,and the difficulty of operation and the incidence of postoperative complications were not increased.2.T3N0 stage of low rectal cancer does not need all of the preoperative neoadjuvant chemotherapy,T3 a N0 patients can be directly performed surgical resection,T3b-c N0 patients with neoadjuvant chemotherapy before surgery can get a good effect.