Ileostomy dysfunction with adjuvant chemoradiation for rectal carcinoma requiring in-hospital management: A cause for concern
ABSTRACT The morbidity and mortality of 20 patients undergoing adjuvant chemoradiation for rectal carcinoma was documented. Of nine patients with defunctioning loop ileostomies, two suffered from dehydration and electrolyte disturbance during the treatment phase and required admission to hospital. These two cases suggest that dehydration and electrolyte disturbance from high stomal output could be a serious problem following chemoradiation therapy in patients with an ileostomy.
- Australian and New Zealand Journal of Surgery 02/1991; 61(1):3-4. DOI:10.1111/j.1445-2197.1991.tb00116.x
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ABSTRACT: Patients with inoperable rectal cancer have a remote chance of 5-year survival. In an attempt to improve this poor prognosis a combined radiochemotherapeutic regimen in a split form followed by long term chemotherapy maintenance was used in their management. From January 1971 until December 1980, three categories of patients were so treated. 100 Patients with an inoperable rectal primary (IP) or locally recurrent after anterior resection (LR) with no evidence of distant metastases; 71 patients with pelviperineal recurrences after rectal amputation (PPR); and 28 patients with primary rectal cancer and asymptomatic liver metastases (PALM). Side effects were tolerable and could be medically controlled. The local response rates in the three groups, respectively, were 79%, 85% and 85%. The median duration of this response lasted 25, 16 and 14 months, respectively, after which there was local progression of disease. The median survival rates were 19, 19 and 13 months, respectively. None of the PALM group lived for more than 30 months, while there were 20% 5-year survivors in the IP-LR group and 15% in the PPR group. The incidence of distant metastases in these last two groups were 20% and 50% at 5 years, respectively, while incidence of late complications was about 10%. This regime offers a good palliative measure with a possible 15% to 20% chance of long-term disease-free survival.Cancer 01/1984; 52(11):2017-24. DOI:10.1002/1097-0142(19831201)52:113.0.CO;2-M · 4.90 Impact Factor
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ABSTRACT: Surgical resection continues to be the primary curative modality for patients with adenocarcinoma of the rectum. However, local tumor recurrence in the pelvis and/or distant metastasis may occur in spite of complete excision of grossly visible malignant disease. Surgical and pathologic staging can identify a subset of surgically treated rectal cancer patients at high risk for tumor relapse and death. Irradiation and chemotherapy have been used as adjuvant therapy in conjunction with surgery as single modalities and in combination for patients with high risk rectal cancer. Evidence from controlled clinical trials indicates a significant decrease in local tumor recurrence, and a significant improvement in disease-free and overall survival with the use of combined postoperative irradiation and chemotherapy in this setting. A current national clinical trial in the United States of America is studying whether irradiation can be combined with new chemotherapy regimens which have shown significant therapeutic benefit as surgical adjuvant therapy for patients with high risk colon cancer (5FU + levamisole) and for patients with metastatic colorectal cancer (5FU + leucovorin) to further improve the efficacy of surgical adjuvant therapy for adenocarcinoma of the rectum.World Journal of Surgery 04/1992; 16(3):510-5. DOI:10.1007/BF02104456 · 2.35 Impact Factor