Is final TNM staging a predictor for survival in locally advanced rectal cancer after preoperative chemoradiation therapy?

Li Jen Kuo, Mei Ching Liu, James Jer Min Jian, Cheng Fang Horng, Tsun I. Cheng, Chung Ming Chen, Wei Tse Fang, Yih Lin Chung

研究成果: 雜誌貢獻文章同行評審

143 引文 斯高帕斯(Scopus)

摘要

Background: Neoadjuvant chemoradiation therapy has improved the local control rate and overall survival in locally advanced rectal cancers. The purpose of this retrospective study is to evaluate the correlation between the final pathologic stage and survival in these patients. Methods: Patients with biopsy-proven rectal carcinoma, pretreatment staging by magnetic resonance imaging such as T3 or T4 tumors, or node-positive disease were treated with preoperative concomitant 5-fluorouracil-based chemotherapy and radiation, followed by radical surgical resection. Clinical outcome with survival, disease-free survival, recurrence rate, and local recurrence rate were compared with each T and N findings using the American Joint Committee on Cancer Tumor-Node-Metastasis (TNM) staging system. Results: A total of 248 patients were enrolled in this study. Overall survival and disease-free survival at 1, 3, and 5 years were 97.1, 92, and 89.9% and 87.5, 71.1, and 69.5%, respectively. Thirty-six patients (14.5%) had a pathologic complete response after neoadjuvant therapy. The recurrence rate was significantly different between the pathologic complete response group and residual group (5.6 vs 31.1%; P = .002). Five-year disease-free survival was significantly better in the complete response group than the residual tumor group (93 vs 66%; P = .0045). There was no statistical difference in survival or locoregional recurrence rate between these two groups. Conclusions: Posttreatment pathologic TNM stage is correlated to disease-free survival and tumor recurrence rate in locally advanced rectal cancer after preoperative chemoradiation. Also, pathologic complete response to neoadjuvant treatment has its oncologic benefit in both overall recurrence and disease-free survival.

原文英語
頁(從 - 到)2766-2772
頁數7
期刊Annals of Surgical Oncology
14
發行號10
DOIs
出版狀態已發佈 - 10月 2007
對外發佈

ASJC Scopus subject areas

  • 手術
  • 腫瘤科

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