Impact of combined treatment for rectal cancer on long-term outcomes
O. K. Bondarenko,
Yu. A. Gevorkyan,
N. V. Soldatkina,
M. A. Gusareva,
N. G. Kosheleva,
A. A. Maslov,
Yu. A. Fomenko,
D. S. Petrov,
E. N. Kolesnikov,
A. N. Shevchenko,
A. V. Shaposhnikov,
D. A. Savchenko,
V. Yu. Gevorkyan,
D. V. Kolesnikov,
O. I. Kit https://doi.org/10.37748/2686-9039-2026-7-2-3
EDN: IVMFSL
Abstract
Purpose of the study. To analyze the effectiveness of combined treatment for rectal cancer and evaluate the impact of ileostomy closure timing on treatment outcomes.
Patients and methods. A study of treatment outcomes in 250 patients with locally advanced rectal cancer was conducted to assess the influence of patient age, sex, tumor characteristics, and timing of ileostomy closure. From January 2020 to November 2025, patients underwent treatment and follow-up including radiotherapy with a total focal dose of 50–54 Gy combined with capecitabine- based radiosensitization, followed by low anterior resection of the rectum with preventive ileostomy formation.
Results. A significant prognostic factor has been established – metastatic involvement of regional lymph nodes (pN2), which increases the risk of death by 3.6 times (p = 0.0001) and the risk of disease progression by 4.1 times (p = 0.0004). Factors such as patients' age, gender, distance from the lower edge of the tumor, the degree of differentiation, and tumor invasion into the colon wall did not show a significant impact on overall survival and progression-free survival rates, which may be due to the limitations of the study (recruitment of a homogeneous group of patients with uniform treatment). No significant differences were found in overall survival rates (p = 0.9573) and progression-free survival rates (p = 0.5278) between groups of patients with ileostomy closure within 2 months and more than 4 months after low anterior resection of the rectum. Closure of the ileostomy within 2 months was accompanied by a decrease in the total number of postoperative complications (p < 0.001), parastomal hernias (p = 0.004), elevated creatinine levels (p = 0.037), the incidence of diversion colitis (p < 0.001), and diarrhea (p = 0.001).
Conclusion. The study confirmed the safety of the approach to closing the ileostomy within 2 months after radical surgery before the start of adjuvant chemotherapy in the combined treatment of rectal cancer. Early closure of the ileostomy is recommended in patients without involvement of regional lymph nodes (pN0) or with involvement of regional lymph nodes (pN1) in the absence of clinical and radiological signs of colorectal anastomosis insufficiency.
About the Authors
O. K. Bondarenko
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Olga K. Bondarenko – oncologist, Department of Abdominal Oncology No. 2, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0002-9543-4551, eLibrary SPIN: 7411-8638, AuthorID: 1223821, Scopus Author ID: 57755642700
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
Yu. A. Gevorkyan
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Yuriy A. Gevorkyan – Dr. Sci. (Medicine), Professor, Head of Department of Abdominal Oncology No. 2, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0003-1957-7363, eLibrary SPIN: 8643-2348, AuthorID: 711165, Scopus Author ID: 57190967507
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
N. V. Soldatkina
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Natalia V. Soldatkina – Dr. Sci. (Medicine), Leading researcher, Department of General Oncology, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0002-0118-4935, eLibrary SPIN: 8392-6679, AuthorID: 440046, Scopus Author ID: 23499757500
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
M. A. Gusareva
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Marina A. Gusareva – Cand. Sci. (Medicine), Head of Radiology Department, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0002-9426-9662, eLibrary SPIN: 9040-5476, AuthorID: 705242, Scopus Author ID: 56613594900
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
N. G. Kosheleva
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Natalia G. Kosheleva – Radiation Oncologist, Department of Radiotherapy, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0001-7630-1502, eLibrary SPIN: 7818-8478, AuthorID: 734155, Scopus Author ID: 57210841195
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
A. A. Maslov
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Andrey A. Maslov – Dr. Sci. (Medicine), Professor, Chief Physician, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0001-7328-8074, eLibrary SPIN: 5963-5915, AuthorID: 817983
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
Yu. A. Fomenko
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Yurii A. Fomenko – Cand. Sci. (Medicine), Deputy General Director for Clinical Expert Affairs, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0001-6513-004X, eLibrary SPIN: 8204-5275, AuthorID: 462430
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
D. S. Petrov
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Dmitry S. Petrov – Cand. Sci. (Medicine), Deputy Chief Physician for Surgery, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0002-4562-1199, eLibrary SPIN: 1855-3496, AuthorID: 736631
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
E. N. Kolesnikov
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Evgeniy N. Kolesnikov – Dr. Sci. (Medicine), Head of Department of Abdominal Oncology No. 1, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0002-8436-7250, eLibrary SPIN: 8434-6494, AuthorID: 347457, Scopus Author ID: 57190297598
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
A. N. Shevchenko
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Alexey N. Shevchenko – Dr. Sci. (Medicine), Professor, Head of Department of Oncourology, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0002-9468-134X, eLibrary SPIN: 2748-2638, AuthorID: 735424
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
A. V. Shaposhnikov
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Aleksandr V. Shaposhnikov – Dr. Sci. (Medicine), Professor, Chief Researcher, Thoracoabdominal Department, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID: https://orcid.org/0000-0001-6881-2281, eLibrary SPIN: 8756-9438, AuthorID: 712823, Scopus Author ID: 7005752070
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
D. A. Savchenko
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Dmitry A. Savchenko – oncologist, Clinical Diagnostic Department, National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
V. Yu. Gevorkyan
https://rostgmu.ru
Rostov State Medical University
Rostov State Medical University
Rostov-on-Don, Russian Federation
Valeria Yu. Gevorkyan – 5th-year student, Faculty of General Medicine and Preventive Care, Rostov State Medical University
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
D. V. Kolesnikov
https://rostgmu.ru
Rostov State Medical University
Rostov State Medical University
Rostov-on-Don, Russian Federation
Daniil V. Kolesnikov – 5th-year student, Faculty of General Medicine and Preventive Care, Rostov State Medical University
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
O. I. Kit
https://rnioi.ru
National Medical Research Centre for Oncology
National Medical Research Centre for Oncology
Rostov-on-Don, Russian Federation
Oleg I. Kit – Dr. Sci. (Medicine), Academician of the Russian Academy of Sciences, Professor, Director General of the National Medical Research Centre for Oncology, Rostov-on-Don, Russian Federation ORCID ID: https://orcid.org/0000-0003-3061-6108, eLibrary SPIN: 1728-0329, AuthorID: 343182, Scopus Author ID: 55994103100, WoS ResearcherID: U-2241-2017
Competing Interests:
Oleg I. Kit is the Editor-in-Chief of the Journal «South Russian Journal of Cancer» and one of the authors of the article. The author Natalia V. Soldatkina is a member of the Journal’s Editorial Board. The article underwent the peer-review procedure adopted by the Journal and was reviewed by independent experts. The authors declared no other conflicts of interest.
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For citations:
Bondarenko O.K., Gevorkyan Yu.A., Soldatkina N.V., Gusareva M.A., Kosheleva N.G., Maslov A.A., Fomenko Yu.A., Petrov D.S., Kolesnikov E.N., Shevchenko A.N., Shaposhnikov A.V., Savchenko D.A., Gevorkyan V.Yu., Kolesnikov D.V., Kit O.I. Impact of combined treatment for rectal cancer on long-term outcomes. South Russian Journal of Cancer. 2026;7(2):34-48. (In Russ.) https://doi.org/10.37748/2686-9039-2026-7-2-3. EDN: IVMFSL
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