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. 2025 Mar 26;29(5):249.
doi: 10.3892/ol.2025.14995. eCollection 2025 May.

Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy

Tuba Kurt Catal  1 , Günay Can  2 , İsmaı L Fatı H Demı Rel  3 , Sefika Arzu Ergen  3 , Dı dem Colpan Öksüz  3
Affiliations

Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy

Tuba Kurt Catal et al. Oncol Lett. .

Abstract

The present study aimed to investigate clinicopathological factors affecting local recurrence and survival in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT) and to create a risk-scoring model predicting local control (LC) and survival. The clinical and pathological data of 115 patients who received nCRT for LARC between February 2010 and December 2020 were reviewed retrospectively. A risk-scoring model was developed to predict LC and survival using statistically significant prognostic factors in univariate and multivariate analyses. In the multivariate analysis, the LC rate was improved in patients with a good pathological response to nCRT. By contrast, the disease-free survival (DFS) rate was significantly worse in patients with perineural invasion (PNI). The overall survival (OS) rate was significantly worse in patients who were >60 years of age, who had tumors ≥5 cm, who were PNI-positive and who had pathological N2 stage disease. Patients were grouped to analyze the ability of the scoring system to predict LC and survival. The total score was derived by assigning points to the prognostic factors in univariate and multivariate analyses and was subsequently divided into three groups according to tertile. The median LC times in groups 1-3 were significantly different at 143.6, 97.2 and 93.6 months, respectively. The median DFS times in groups 1-3 were significantly different at 136.1, 108.5 and 67.2 months, respectively, while the median OS times in groups 1-3 were significantly different at 138.3, 87.2 and 64.6 months, respectively. In conclusion, risk score modeling with prognostic factors effectively determined the difference in LC and survival between the groups. Adding effective systemic therapy to nCRT may improve results, especially in patients with multiple poor prognostic factors, including larger tumors, PNI and multiple nodal involvement.

Keywords: neoadjuvant chemoradiotherapy; prognostic factors; rectal cancer; risk score modeling.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
ROC curve of the risk score model for local control. ROC, receiver operating characteristic.
Figure 2.
Figure 2.
ROC curve of the risk score model for disease-free survival. ROC, receiver operating characteristic.
Figure 3.
Figure 3.
ROC curve of the risk score model for overall survival. ROC, receiver operating characteristic.
Figure 4.
Figure 4.
LC curves based on groups. LC, local control.
Figure 5.
Figure 5.
DFS curves based on groups. DFS, disease-free survival.
Figure 6.
Figure 6.
OS curves based on groups. OS, overall survival.
See this image and copyright information in PMC

References

    1. Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol. 2021;14:101174. doi: 10.1016/j.tranon.2021.101174. - DOI - PMC - PubMed
    1. Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rödel Cd, Cervantes A, Arnold D, ESMO Guidelines Committee Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28:iv22–iv40. doi: 10.1093/annonc/mdx224. - DOI - PubMed
    1. Yang J, Deng Q, Cheng Y, Fu Z, Wu X. Effect of adjuvant chemotherapy on the oncological outcome of rectal cancer patients with pathological complete response. World J Surg Oncol. 2024;22:31. doi: 10.1186/s12957-024-03300-0. - DOI - PMC - PubMed
    1. Johnson GG, Park J, Helewa RM, Goldenberg BA, Nashed M, Hyun E. Total neoadjuvant therapy for rectal cancer: A guide for surgeons. Can J Surg. 2023;66:E196. doi: 10.1503/cjs.005822. - DOI - PMC - PubMed
    1. Neves ALF, Barbosa LER, Teixeira JPMdA. Prognosis in colorectal cancer beyond TNM. J Coloproctology (Rio de Janeiro) 2020;40:404–411. doi: 10.1016/j.jcol.2020.06.010. - DOI

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