CLINICAL-EVALUATION OF NERVE-SPARING SURGERY COMBINED WITH PREOPERATIVE RADIOTHERAPY IN ADVANCED RECTAL-CANCER PATIENTS

BACKGROUND: Since 1984, we have studied nerve-sparing surgery (NSS) co mbined with preoperative radiotherapy (XRT) in patients with advanced rectal cancer to preserve the genitourinary function without compromis ing radicality. The present aim was to evaluate the prognosis and the postoperative genitourinary function. METHODS: A total of 167 patients with advanced rectal cancer underwent curative nerve-sparing surgery. Among them, 60 underwent the preoperative therapy using irradiation ( 42.6 Gy) and tegafur suppository. Survival, local recurrence, and post operative genitourinary function were investigated in these patients. RESULTS: The 5-year survival rate was 80.9% and the local recurrence r ate was 6.7% in the NSS+XRT group. Almost all of the patients receivin g NSS could micturate spontaneously, but preservation of sexual functi on was not as successful. CONCLUSIONS: Better local control and preser vation of urinary function were possible in advanced rectal cancer pat ients by NSS+XRT. (C) 1998 by Excerpta Medica, Inc.