Results of surgical treatment of adenocarcinoma of the middle rectum: a comparative study between patients submitted to adjuvant chemotherapy, with and without neoadjuvant chemo and radiotherapy

A cirurgia ainda é o principal método de tratamento do câncer do reto. Recentemente a quimio e radioterapia neo-adjuvantes têm sido preconizadas, com freqüência cada vez maior, com o intuito de reduzir os índices de recidiva e mortalidade. O objetivo desse estudo foi avaliar, retrospectivamente a sobrevida e a recidiva tumoral de pacientes submetidos a quimioterapia adjuvante, com e sem quimio e radioterapia neoadjuvantes. Foram avaliados retrospectivamente 36 pacientes submetidos a ressecção anterior baixa por adenocarcinoma do reto. Subdivididos em três grupos: grupo I (N=11), submetidos exclusivamente a tratamento cirúrgico; grupo II (N=8), submetidos a tratamento cirúrgico, seguido de quimioterapia adjuvante; grupo III (N=17), submetidos a tratamento cirúrgico com quimio e radioterapia neo-adjuvantes. O período de seguimento foi de 36 meses. Seis pacientes (16,6%) apresentaram recidiva, sendo 1 paciente do grupo I, 3 pacientes do grupo II e 2 pacientes do grupo III. A sobrevida global foi de 88,9%, assim distribuída: grupo I, 80,0%; grupo II, 100,0% e grupo III, 87,5%. Não houve diferença significante nos índices de recidiva nem na sobrevida entre os grupos. Concluiu-se que na amostra estudada os métodos terapêuticos tiveram resposta equivalente, não tendo sido possível demonstrar a interferência da quimio e ou radioterapia nos índices de sobrevida ou recidivaSurgery continues to be the principal method for treating cancer of the rectum. Recently, chemo and neo-adjuvant radiotherapy have been considered, with increasing frequency, with the intention of reducing the rates of recurrence and mortality. The objective of this study was to evaluate, retrospectively, survival and tumor recurrence in patients submitted to adjuvant chemotherapy, with and without neo-adjuvant chemo and radiotherapy. A retrospective evaluation of 36 patients submitted to lower anterior resection for adenocarcinoma of the rectum was conducted, subdivided into three groups: Group I (n=11), submitted exclusively to surgical treatment; Group II (n=8), submitted to surgical treatment followed by adjuvant chemotherapy; Group III (n=17), submitted to surgical treatment with chemo and neo-adjuvant radiotherapy. The time period was 36 months. Six patients (16.6%) presented recurrence: 1 patient from Group I, 3 patients from Group II and 2 patients from Group III. Overall survival was 88.9%, distributed in the following way: Group I, 80.0%; Group II, 100.0% and Group III, 87.5%. No significant differences in the rates of recurrence and survival were observed between the groups. It is therefore concluded that within the sample the therapeutic methods had similar response, not having been possible to demonstrate the interference of chemo and radiotherapy in the rates of survival or recurrenc