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. 2015 May 10;6(13):11714-22.
doi: 10.18632/oncotarget.3418.

Implications for selecting local excision in locally advanced rectal cancer after preoperative chemoradiation

Juefeng Wan  1   2 , Kaitai Liu  3 , Ji Zhu  1   2 , Guichao Li  1   2 , Zhen Zhang  1   2
Affiliations

Implications for selecting local excision in locally advanced rectal cancer after preoperative chemoradiation

Juefeng Wan et al. Oncotarget. .

Abstract

Local excision may offer the possibility of organ preservation for the management of locally advanced rectal cancer after neoadjuvant chemoradiotherapy (CRT). However, the oncological outcomes of this strategy have been largely associated with the risk of nodal metastases. In this study, Surveillance, Epidemiology, and End Results Program (SEER)-registered rectal cancer patients, and patients from Fudan University Shanghai Cancer Center (FUSCC) after preoperative chemoradiation were combined to analyze the incidence of lymph node metastasis. The results showed that there was a high risk for residual lymph node metastasis among patients even with complete pathologic response of primary tumor after preoperative CRT (12.6-13.2%). However, in the selected group of patients with pre-CRT MRI staging cN0 rectal cancer, there was only one ypN+ case (3.3%) in ypT0-1 group. These results suggest that pre-CRT MRI staging cN0 patients achieved ypT0-1 of bowel wall tumor may be suitable for local resection.

Keywords: chemoradiotherapy; local excision; positive lymph nodes; rectal cancer; seer.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare that they have no competing interests.

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