¹Radiotherapy Department, Habib Bourguiba Hospital, University of Sfax, Tunisia

²Medical oncology Department, Habib Bourguiba Hospital, University of Sfax, Tunisia

³Surgery Department, Habib Bourguiba Hospital, University of Sfax, Tunisia

⁴Anatomopathology Department, Habib Bourguiba Hospital, University of Sfax, Tunisia

⁵Radiology Department, Habib Bourguiba Hospital, University of Sfax, Tunisia

*Corresponding Author: Inès AYADI, Radiotherapy Department, Habib Bourguiba Hospital, University of Sfax, Tunisia; Tel: +21697266914; Email: [email protected]

Received Date: October 10, 2023

Publication Date: October 23, 2023

Citation: Sirine Z, et al. (2023). Prognostic Factors of Locally Advanced Non Metastatic Rectal Cancer in Tunisia. Mathews J Case Rep. 8(9):127.

Copyright: Sirine Z, et al. © (2023)

ABSTRACT

Introduction: Multimodal treatment based on radio chemotherapy and surgery has improved the local control rate of rectal cancer, but the metastatic relapse rate and overall survival remained stable. The purpose of our study was to analyze the prognostic factors of Overall survival (OS), event-free survival (EFS), locoregional recurrence-free (LFS) and metastasis-free survival (MFS). Patients and methods: It was a retrospective study of patients with locally advanced non-metastatic rectal cancer treated with radio-chemotherapy and surgery at Habib Bourguiba Sfax University Hospital from January 2009 to December 2017. Results: We collected 66 patients. 5-year OS and EFS were 53% and 60% respectively, and the 5-year DFS was 82%. DFS at 5 years was 73%. In multivariate analysis, the independent prognostic factors retained for OS were tumor perforation (p=0.02) peri-nervous sheathing (p=0.03) and presence of recurrence (p=0.04). Factors that significantly influenced EFS were delays in adjuvant CT beyond 8 weeks (p=0.009), presence of lymphovascular emboli (p=0.04), and invaded circumferential boundaries (p=0.03). An invaded circumferential margin was the only variable significantly influencing LFS survival in multivariate study (p = 0.02). The presence of peri-neural engorgement and lymph node invasion on anatomopathological examination of the surgical specimen were retained as pejorative prognostic factors of metastatic recurrence (p = 0.02). Conclusion: The prognosis of rectal cancers remains reserved. Accurate pre-treatment evaluation and optimization of neoadjuvant treatment according to disease prognostic factors could improve oncological outcomes. Conclusion: The prognosis of rectal cancers remains reserved. Accurate pre-treatment evaluation and optimization of neoadjuvant treatment according to disease prognostic factors could improve oncological outcomes.

Keywords: Radiotherapy, Chemotherapy, Rectal cancer