Randomized, controlled trial of lateral node dissection vs. nerve-preserving resection in patients with rectal cancer after preoperative radiotherapy
Randomized, controlled trial of lateral node dissection vs. nerve-preserving resection in patients with rectal cancer after preoperative radiotherapy
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DOI：
10.1007/bf02234784
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发表时间：
2001-09-01
影响因子：
3.9
通讯作者：
Sawada, T
中科院分区：
文献类型：
--
作者：
Nagawa, H;Muto, T;Sawada, T
目的：在一项前瞻性、随机、对照研究中，研究术前放疗对晚期下直肠癌保留盆腔器官功能和减少局部复发的有效性。方法：51例诊断为局部可切除腺癌的患者。在1993年4月至1995年3月期间，接受50 Gy术前放疗的下直肠患者被纳入试验。患者随机分为两组，一组完成保留自主神经的手术，但不切除外侧淋巴结（D1），另一组切除包括自主神经在内的外侧淋巴结（D2），术后口服卡莫福1年。结果：D1组和D2组的生存期和无病生存期均无差异。两组的复发率无明显差异。D1组与D2组术后1年尿功能、性功能差异有统计学意义（P = 0.02、0.02）。结论：本研究提示晚期下直肠癌术前行放疗的患者无需行侧结清扫术。
PURPOSE: The effectiveness of preoperative radiation therapy for advanced lower rectal carcinoma to preserve the function of pelvic organs and reduce local recurrences was examined in a prospective, randomized, controlled study. METHODS: Fifty-one patients with a diagnosis of localized and resectable adenocarcinoma. of the lower rectum undergoing 50 Gy of preoperative radiotherapy were recruited into the trial between April 1993 and March 1995. The patients were randomly allocated to complete autonomic nerve-preserving surgery without lateral node dissection (D1), or surgery with dissection of the lateral lymph nodes including autonomic nerves (D2) followed by oral administration of carmofur for one year. RESULTS: No difference was observed in either survival or disease-free survival between D1 and D2 groups. There was no difference between the two groups in terms of recurrence rate. A significant difference was observed in urinary and sexual function (P = 0.02 and 0.02, respectively) one year after surgery between D1 and D2 groups. CONCLUSION: This study suggests that lateral node dissection is not necessary in terms of curability for patients with advanced carcinoma of the lower rectum who undergo preoperative radiotherapy.