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Patients with ECF can be treated with low morbidity and low recurrence rate in a multidisciplinary setting. We believe that patients with ECF should be referred to specialist units for management.

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The morbidity of postoperative adjuvant chemoradiation for primary extraperitoneal rectal carcinoma is documented in this ongoing study. Patients who presented electively for resection with ACPS Dukes' B and C extraperitoneal rectal carcinoma during the period January 1990 to June 1993 were studied. Twenty patients received postoperative adjuvant chemoradiation. At a mean follow up of 32.6 months (s. d. 7.1), three of the 20 patients who received combined adjuvant chemoradiation reported no side effects. In 10 patients (50%) complications were classified as minor. In the remaining seven patients (35%) major complications of therapy occurred. There were no deaths. These early results highlight the morbidity of postoperative adjuvant chemoradiation that has been presumed but not documented.