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. 2015 Jan 14;21(2):563-70.
doi: 10.3748/wjg.v21.i2.563.

Impression of prognosis regarding pathologic stage after preoperative chemoradiotherapy in rectal cancer

Kyungyeon Hwang  1 , In Ja Park  1 , Chang Sik Yu  1 , Seok-Byung Lim  1 , Jong Lyul Lee  1 , Yong Sik Yoon  1 , Chan Wook Kim  1 , Jin Cheon Kim  1
Affiliations

Impression of prognosis regarding pathologic stage after preoperative chemoradiotherapy in rectal cancer

Kyungyeon Hwang et al. World J Gastroenterol. .

Abstract

Aim: To ascertain pathologic stage as a prognostic indicator for rectal cancer patients receiving preoperative chemoradiotherapy (PCRT).

Methods: Patients with mid- and low rectal carcinoma (magnetic resonance imaging - based clinical stage II or III) between 2000 and 2009 and treated with curative radical resection were identified. Patients were divided into two groups: PCRT and No-PCRT. Recurrence-free survival (RFS) was examined according to pathologic stage and addition of adjuvant treatment.

Results: Overall, 894 patients were identified. Of these, 500 patients received PCRT. Adjuvant chemotherapy was delivered to 81.5% of the No-PCRT and 94.8% of the PCRT patients. Adjuvant radiotherapy was given to 29.4% of the patients in the No PCRT group. The 5-year RFS for the No-PCRT group was 92.6% for Stage I, 83.3% for Stage II, and 72.9% for Stage III. The 5-year RFS for the PCRT group was 95.2% for yp Stage 0, 91.7% for yp Stage I, 73.9% for yp Stage II, and 50.7% for yp Stage III.

Conclusion: Pathologic stage can predict prognosis in PCRT patients. 5-year RFS is significantly lower among PCRT patients than No-PCRT patients in pathologic stage II and III. These results should be taken into account when considering adjuvant treatment for patients treated with PCRT.

Keywords: Chemoradiotherapy; Pathologic stage; Preoperative; Prognosis; Rectal cancer.

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Figures

Figure 1
Figure 1
Recurrence-free survival according to pathologic stage. A: p Stage 0; B: p Stage I vs yp Stage I; C: p Stage II vs yp Stage II; D: p Stage III vs yp Stage III. PCRT: Preoperative chemoradiotherapy.
Figure 2
Figure 2
Recurrence-free survival of patients with yp Stage III disease treated with different adjuvant chemotherapy regimens. Patients with yp Stage III that received a different second-line chemotherapy regimen had longer recurrence-free survival than patients receiving a regimen that was the same as the preoperative concurrent regimen.
See this image and copyright information in PMC

References

    1. NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990;264:1444–1450. - PubMed
    1. Chan AK, Wong AO, Langevin J, Jenken D, Heine J, Buie D, Johnson DR. Preoperative chemotherapy and pelvic radiation for tethered or fixed rectal cancer: a phase II dose escalation study. Int J Radiat Oncol Biol Phys. 2000;48:843–856. - PubMed
    1. Theodoropoulos G, Wise WE, Padmanabhan A, Kerner BA, Taylor CW, Aguilar PS, Khanduja KS. T-level downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved disease-free survival. Dis Colon Rectum. 2002;45:895–903. - PubMed
    1. Janjan NA, Crane C, Feig BW, Cleary K, Dubrow R, Curley S, Vauthey JN, Lynch P, Ellis LM, Wolff R, et al. Improved overall survival among responders to preoperative chemoradiation for locally advanced rectal cancer. Am J Clin Oncol. 2001;24:107–112. - PubMed
    1. Valentini V, Coco C, Picciocchi A, Morganti AG, Trodella L, Ciabattoni A, Cellini F, Barbaro B, Cogliandolo S, Nuzzo G, et al. Does downstaging predict improved outcome after preoperative chemoradiation for extraperitoneal locally advanced rectal cancer? A long-term analysis of 165 patients. Int J Radiat Oncol Biol Phys. 2002;53:664–674. - PubMed

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