EXTENDED LYMPHADENECTOMY AND THE QUALITY-OF-LIFE IN RECTAL-CANCER PATIENTS

For a better quality of life in rectal cancer patients, high dose radi otherapy following abdominoperineal resection of the rectum with a pel vic partition is another surgical option replacing extended abdominope rineal resection. In addition to pelvic partition with polyglycolic ac id mesh, the tissue expander was inserted into the pelvic cavity to su pport the intestine upward and the bladder forward. The mean total rad iation dosage was 5040 cGy. Between 1989 and 1991, 10 patients were tr eated according to this method. Out of 10 patients 9 were free of recu rrence, and only one had hepatic metastasis. In addition, postoperativ ely, the average residual urine by this method was 39.1 mi and was sta tistically different compared to a figure of 200 mi in conventional ab dominoperineal resections (p<0.001, ''t''-test). In order to individua lize the operative procedures among a variety of surgical options, the molecular biological technique was utilized. In p53 stain analysis of 114 colorectal cancer patients, patients with p53 positive staining r eached a higher stage than those with p53 negative staining (p<0.05, X (2) analysis). Therefore, we surmised that the positivity of the p53 s tain could be one of the factors gauged as an indication of postoperat ive high-dose radiation. In conclusion, high-dose postoperative radiot herapy was thought to be one of the treatment modalities to improve th e survival and quality of life of advanced rectal cancer in selected c ases.