대한대장항문학회

Purpose : The exact role of postoperative radiotherapy following curative surgery of rectal<br>carcinoma has been debated. In this retrospective study, we examined the effect of<br>radiotherapy on the survival and recurrence rate of rectal cancer patients who underwent<br>total mesorectal excision (TME). Methods : Since June of 1994, we have recommended<br>postoperative chemoradiation (6 cycles of 5-FU with folinic acid plus 5040 cGy external<br>irradiation) for stage II and III rectal cancer patients. Among 134 stage II and III rectal cancer<br>patients who underwent TME, 100 patients received postoperative chemoradiation (group A)<br>and 34 patients decided not to receive radiation therapy (group B). For these two groups,<br>survival and recurrence rates were compared. Follow-up times were 6 to 60 months (mean<br>24.7). There was no difference between two groups with regard to sex, stage of the disease,<br>mean tumor location from dentate line, status of lateral margins, type of operation and mean<br>follow-up duration. However, mean age was higher in group B (65.6 vs 53.9, P＜0.05).<br>Results : The overall recurrence rate showed no difference between two groups (28.0% in<br>group A vs 21.0% in group B, P＞0.05). Local recurrence rate was also similar (11.0% vs<br>3.0%). There was no significant difference in duration between surgery and initial recurrence<br>(14.0 months vs 11.0 months, P=0.18). The 5-year-disease-free survival rate was 57.0% in<br>group A and 63.0% in group B (P=0.33). Conclusion : In this study, we found no beneficial<br>effect of postoperative radiation therapy following TME for the rectal cancer.<br>