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Oncologic impact of pathologic response on clinical outcome after preoperative chemoradiotherapy in locally advanced rectal cancer.

Yoon WH, Kim HJ, Kim CH, Joo JK, Kim YJ, Kim HR - Ann Surg Treat Res (2014)

Bottom Line: Patients with yp-stage III had a greater prevalence of preoperative CEA, poorly differentiated tumor, lymphovascular invasion (LVI) and perineural invasion (PNI) than patients with lower yp-stages.We found that yp-stage, preoperative CEA, LVI, PNI and tumor regression grade were significant prognostic factors for both local and systemic recurrence.In multivariate analysis, yp-stage, LVI and PNI were significant factors for local and systemic recurrence.

View Article: PubMed Central - PubMed

Affiliation: Division of Colorectal Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT

Purpose: Downstaging after chemoradiotherapy (CRT) for rectal cancer usually occurs. The present study aimed to evaluate pathologic y-stage (yp-stage) and its influence on local recurrence and systemic recurrence in rectal cancer patients treated with CRT followed by surgical resection.

Methods: We retrospectively analyzed 261 patients underwent preoperative CRT and radical resection for rectal cancer between August 2004 and December 2010. Patients received preoperative CRT consisting of 5-fluorouracil and leucovorin delivered with concurrent pelvic radiation of 45.0-50.4 Gy, followed by radical surgery at 6-8 weeks after CRT.

Results: Of the 261 patients, 24 (9.2%) had yp-stage 0, 83 (31.8%) had yp-stage I, 86 (32.9%) had yp-stage II, and 68 (26.1%) had yp-stage III. Patients with yp-stage III had a greater prevalence of preoperative CEA, poorly differentiated tumor, lymphovascular invasion (LVI) and perineural invasion (PNI) than patients with lower yp-stages. We found that yp-stage, preoperative CEA, LVI, PNI and tumor regression grade were significant prognostic factors for both local and systemic recurrence. In multivariate analysis, yp-stage, LVI and PNI were significant factors for local and systemic recurrence. During the median follow-up of 37.5 months, the five-year local recurrence-free survival rate was 100.0%, 95.0%, 89.3%, and 80.6% of yp-stage 0-III, respectively. The five-year systemic recurrence-free survival was 95.8%, 75.3%, 71.4%, and 48.8% of yp-stages 0-III, respectively.

Conclusion: The yp-stage after preoperative CRT for rectal cancer is closely correlated with local and systemic recurrence-free survival. Therefore, yp-stage should be considered as a prognostic factor for rectal cancer patients having a course of preoperative CRT.

No MeSH data available.


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Proportion of five-year systemic recurrence-free survival. yp-stage, pathologic y-stage.
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Figure 3: Proportion of five-year systemic recurrence-free survival. yp-stage, pathologic y-stage.

Mentions: The median follow-up period was 37.5 months. Local and systemic recurrence occurred in 25 (9.58%) and 60 patients (22.99%). There was a significant correlation between yp-stage and five-year LRFS and SRFS. The five-year LRFS was 100.0% for yp-stage 0, 95.0% for yp-stage I, 89.3% for yp-stage II, and 80.6% for yp-stage III (Fig. 2) (P = 0.005). The five-year SRFS was 95.8% for yp-stage 0, 75.3% for yp-stage I, 71.4% for yp-stage II, and 48.8% for yp-stage III (Fig. 3) (P < 0.001).


Oncologic impact of pathologic response on clinical outcome after preoperative chemoradiotherapy in locally advanced rectal cancer.

Yoon WH, Kim HJ, Kim CH, Joo JK, Kim YJ, Kim HR - Ann Surg Treat Res (2014)

Proportion of five-year systemic recurrence-free survival. yp-stage, pathologic y-stage.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279989&req=5

Figure 3: Proportion of five-year systemic recurrence-free survival. yp-stage, pathologic y-stage.
Mentions: The median follow-up period was 37.5 months. Local and systemic recurrence occurred in 25 (9.58%) and 60 patients (22.99%). There was a significant correlation between yp-stage and five-year LRFS and SRFS. The five-year LRFS was 100.0% for yp-stage 0, 95.0% for yp-stage I, 89.3% for yp-stage II, and 80.6% for yp-stage III (Fig. 2) (P = 0.005). The five-year SRFS was 95.8% for yp-stage 0, 75.3% for yp-stage I, 71.4% for yp-stage II, and 48.8% for yp-stage III (Fig. 3) (P < 0.001).

Bottom Line: Patients with yp-stage III had a greater prevalence of preoperative CEA, poorly differentiated tumor, lymphovascular invasion (LVI) and perineural invasion (PNI) than patients with lower yp-stages.We found that yp-stage, preoperative CEA, LVI, PNI and tumor regression grade were significant prognostic factors for both local and systemic recurrence.In multivariate analysis, yp-stage, LVI and PNI were significant factors for local and systemic recurrence.

View Article: PubMed Central - PubMed

Affiliation: Division of Colorectal Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT

Purpose: Downstaging after chemoradiotherapy (CRT) for rectal cancer usually occurs. The present study aimed to evaluate pathologic y-stage (yp-stage) and its influence on local recurrence and systemic recurrence in rectal cancer patients treated with CRT followed by surgical resection.

Methods: We retrospectively analyzed 261 patients underwent preoperative CRT and radical resection for rectal cancer between August 2004 and December 2010. Patients received preoperative CRT consisting of 5-fluorouracil and leucovorin delivered with concurrent pelvic radiation of 45.0-50.4 Gy, followed by radical surgery at 6-8 weeks after CRT.

Results: Of the 261 patients, 24 (9.2%) had yp-stage 0, 83 (31.8%) had yp-stage I, 86 (32.9%) had yp-stage II, and 68 (26.1%) had yp-stage III. Patients with yp-stage III had a greater prevalence of preoperative CEA, poorly differentiated tumor, lymphovascular invasion (LVI) and perineural invasion (PNI) than patients with lower yp-stages. We found that yp-stage, preoperative CEA, LVI, PNI and tumor regression grade were significant prognostic factors for both local and systemic recurrence. In multivariate analysis, yp-stage, LVI and PNI were significant factors for local and systemic recurrence. During the median follow-up of 37.5 months, the five-year local recurrence-free survival rate was 100.0%, 95.0%, 89.3%, and 80.6% of yp-stage 0-III, respectively. The five-year systemic recurrence-free survival was 95.8%, 75.3%, 71.4%, and 48.8% of yp-stages 0-III, respectively.

Conclusion: The yp-stage after preoperative CRT for rectal cancer is closely correlated with local and systemic recurrence-free survival. Therefore, yp-stage should be considered as a prognostic factor for rectal cancer patients having a course of preoperative CRT.

No MeSH data available.


Related in: MedlinePlus