Long-term outcomes of surgery alone versus surgery following preoperative chemoradiotherapy for early T3 rectal cancer

Cho, Seung-Hyun; Choi, Gyu–Seog; Kim, Gab Chul; Seo, An Na; Kim, Hye Jung; Kim, Won Hwa; Shin, Kyung-Min; Lee, So Mi; Ryeom, Hunkyu; Kim, See Hyung

doi:10.1097/md.0000000000006362

Cited by 12 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Post‐nCRT EMVI positivity also indicates reduced survival . The depth of invasion of a malignant tumor beyond the outer border of the muscularis propria (pT3) is considered an important prognostic factor in rectal carcinoma, with a pT3 depth above 5 mm representing an adverse prognostic factor for DFS (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.16–3.89) . Studies have also shown that the pathologic T category (ypT) and N stage (ypN) after nCRT are relevant independent prognostic factors for survival .…”

mentioning

confidence: 99%

Novel radiomic signature as a prognostic biomarker for locally advanced rectal cancer

Meng

Zhang

Dong

et al. 2018

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Novel radiomic signature as a prognostic biomarker for locally advanced rectal cancer

Meng

Zhang

Dong

et al. 2018

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…Therefore, the results with improved OS with PRCT in recto-sigmoid colon cancers must be interpreted with caution. In another study, early T3 rectal cancer patients who were either treated with surgery alone versus PRCT showed that 5-year local recurrence rate was 2% for both groups, and 5-year DFS were not statistically different (87% in surgery alone versus 88% in PRCT group) ( 33 ). Recently, a meta-analysis on total neoadjuvant therapy (TNT) addressed that TNT increases pathological down staging compared with surgery and adjuvant CRT ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Role of Preoperative Chemoradiotherapy in Clinical Stage II/III Rectal Cancer Patients Undergoing Total Mesorectal Excision: A Retrospective Propensity Score Analysis

et al. 2021

View full text Add to dashboard Cite

BackgroundAlthough the current standard preoperative chemoradiotherapy (PCRT) for stage II/III rectal cancer decreases the risk of local recurrence, it does not improve survival and increases the likelihood of preoperative overtreatment, especially in patients without circumferential resection margin (CRM) involvement.MethodsStage II/III rectal cancer without CRM involvement and lateral lymph node metastasis was radiologically defined by preoperative magnetic resonance imaging (MRI). Patients who received PCRT followed by total mesorectal excision (TME) (PCRT group) and upfront surgery (US) with TME (US group) between 2010 and 2016 were analyzed. We derived cohorts of PCRT group versus US group using propensity-score matching for stage, age, and distance from the anal verge. Three-year relapse-free survival rate, disease-free survival (DFS), and overall survival (OS) were compared between the two groups.ResultsA total of 202 patients were analyzed after propensity score matching. There were no differences in baseline characteristics. The median follow-up duration was 62 months (interquartile range, 46–87). There was no difference in the 3-year disease-free survival rate between the PCRT and US groups (83 vs. 88%, respectively; p=0.326). Likewise, there was no significant difference in the 3-year OS (89 vs. 91%, respectively; p=0.466). The 3-year locoregional recurrence rates (3 vs. 2% with US, p=0.667) and distant metastasis rates (16 vs. 11%, p=0.428) were not significantly different between the two groups. Time to completion of curative treatment was significantly shorter in the US group (132 days) than in the PCRT group (225 days) (p<0.001).ConclusionUsing MRI-guided selection for better risk stratification, US without neoadjuvant therapy can be considered in early stage patients with good prognosis. PCRT may not be required for all stage II/III rectal cancer patients, especially for the MRI-proven intermediate-risk group (cT1-2/N1, cT3N0) without CRM involvement and lateral lymph node metastasis. Further prospective studies are warranted.

show abstract

“…Es konnte gezeigt werden, dass sich Lokalrezidivrate und rezidivfreies Überleben bei frühen T3-Stadien (pT3ab) und fehlender Infiltration der mesorektalen Fasziebasierend auf der MRT-Einschätzungmit und ohne neoadjuvante Radio-Chemotherapie nicht unterscheiden [28]. Diese Ergebnisse haben noch nicht zu einer Änderung der Therapieempfehlungen in der aktuellen Version der Leitlinie geführt [8].…”

Section: Bedeutung Der Mesorektalen Faszieunclassified

Rektale Endosonografie – Stellenwert in der Gastroenterologie

Jürgensen¹

2017

Gastroenterologie up2date

View full text Add to dashboard Cite

Long-term outcomes of surgery alone versus surgery following preoperative chemoradiotherapy for early T3 rectal cancer

Abstract: Supplemental Digital Content is available in the text

Cited by 12 publications

References 27 publications

Novel radiomic signature as a prognostic biomarker for locally advanced rectal cancer

Novel radiomic signature as a prognostic biomarker for locally advanced rectal cancer

Role of Preoperative Chemoradiotherapy in Clinical Stage II/III Rectal Cancer Patients Undergoing Total Mesorectal Excision: A Retrospective Propensity Score Analysis

Rektale Endosonografie – Stellenwert in der Gastroenterologie

Contact Info

Product

Resources

About