Abstract
We examined the validity of the strategy of neoadjuvant chemotherapy (NAC) for obstructive rectal cancer. Focusing on 55 cases of obstructive rectal cancer diagnosed between 2000 and 2012, we examined and compared the treatment results between the NAC group (15 cases) and the non-NAC group (40 cases). In the NAC group, L-OHP was administered in 93% and L-OHP with bevacizumab in 86% of patients. The response rate to NAC was 73.4% and there were no cases of PD. In addition, the antitumor effect of the treatment led to significant shrinkage of the tumor and a large number of cases with improvement of the N grade to N0 in the NAC group. The rate of R0 was 100% in the NAC group, and 82.5% in the non-NAC group, and there were no cases requiring total pelvic exenteration. There was no significant difference in the incidence of postoperative complication or reoperation between the two groups. There was no difference in the 3-year local recurrence-free survival rate, 3-year recurrence free rate, or 3-year survival rate between the two groups. Therefore, our findings suggested that the use of NAC for obstructive rectal cancer is an effective treatment strategy in terms of reducing the disease stage and is equivalent in terms of the safety.
