Oncological Outcomes of Pathological T1 Lower Rectal Cancer Patients With or Without Preoperative Chemoradiotherapy

Abstract

Background/Aim: It remains unclear whether rectal cancers down-staged by preoperative chemoradiotherapy (CRT) have similar prognoses to those of the same stage without preoperative CRT. We compared prognoses of pT1 rectal cancer patients stratified by preoperative CRT. Patients and Methods: We retrieved data of patients with pathological T1 rectal cancer between 2003 and 2020. Patients were divided into the "ypT1 group" who received preoperative CRT following surgery and the "pT1 group" who underwent surgery alone. Factors associated with relapse-free survival (RFS) were investigated. Results: Among 86 patients, ypT1 and pT1 groups comprised 18 and 68 patients, respectively. There was no significant difference in RFS between the groups (p=0.19). Tumor location within 5 cm from the anal verge was associated with recurrence (hazard ratio: 0.13, p=0.034). Conclusion: The prognosis of patients with ypT1 rectal cancer was similar to that of patients with pT1. Low tumor location was a poor prognostic factor.

Prognoses in Pathologically Confirmed T1 Lower Rectal Cancer Patients with or without Preoperative Therapy: An Analysis Using the Surveillance, Epidemiology, and End Results Database

“…In the current study, we have performed a similar analysis using the data from >3,000 ypT1 or pT1 patients available in the SEER database and showed that (i) there was no difference in OS between ypT1 and pT1 rectal cancer patients and (ii) preoperative therapy was not a prognostic factor of CSS or OS. Importantly, these results are consistent with our previous observations in a single-center cohort of 86 patients [14].…”

“…We previously reported on the prognosis of 18 patients with ypT1N0 stage lower rectal cancer in comparison with 68 patients with pT1N0 stage cancer who did not undergo preoperative CRT in our hospital and showed that there was no difference in RFS between ypT1 and pT1 patients; preoperative CRT was not a prognostic factor [14]. In the current study, we have performed a similar analysis using the data from >3,000 ypT1 or pT1 patients available in the SEER database and showed that (i) there was no difference in OS between ypT1 and pT1 rectal cancer patients and (ii) preoperative therapy was not a prognostic factor of CSS or OS.…”

“…However, their study contained an obvious bias in the number of (y)pT1 and (y)pT2 patients with and without preoperative CRT, and this predominance might have contributed to reduced survival in patients receiving CRT. In contrast, we previously conducted a single-center study that included only patients with lower rectal cancer with a pathological T1 stage, demonstrating that there was no difference in relapse-free survival (RFS) between ypT1 and pT1 patients [14]. One of the limitations of that study was a small sample size (86 patients).…”

[Retracted] Study on Ultrasonographic Diagnosis and Postoperative Comprehensive Nursing of Rectal Cancer in Preoperative Staging

“…Taira, T. et al performed preoperative rectal ultrasound examination in 52 patients with rectal cancer and compared the ultrasound examination results with postoperative pathological results. The objective of this study was to further evaluate the accuracy and influencing factors of intravascular ultrasound in preoperative diagnosis of rectal cancer staging and to study the relationship between preoperative intravascular ultrasound staging and preoperative serum carcinoembryonic antigen (CEA) value [ 12 ].…”