• For tumors near the anus, radiation therapy followed by surgery may allow sphincter function to be preserved.
Preoperative or postoperative radiation therapy has resulted in fewer local recurrences but has never been definitely shown to affect survival.
Five-Year Survival 30 to 70 percent (50 to 70 percent for Dukes' B2, 30 percent for Dukes' B3)
Investigational New adjuvant programs may increase survival by 10 to 15 percent.
• Adjuvant 5-FU + leucovorin and radiotherapy .
• 5-FU + levamisole and 5-FU + PALA.
• Giving radiation during surgery (intraoperative radiation therapy) is being evaluated for locally advanced disease.
Stage III ( see Stage III colon diagram ) (Dukes' C1, 2, 3)
TNM Any T, N1-3, M0
The cancer has spread within or outside the rectum and one or more lymph nodes are involved. A Dukes' C1 tumor is within the bowel wall, C2 is through the bowel wall, and C3 involves adjacent structures.
Standard Treatment The number of lymph nodes that are positive for cancer needs to be known because patients with one to four positive nodes have a better prognosis than those with five or more involved nodes.
