방사선종양학

본문글자크기
  • [Int J Colorectal Dis.] Determining whether postoperative chemoradiotherapy is required in patients with pathologic T3N0 rectal cancer with negative resection margin

    성균관의대 / 백종윤, 박희철*, 유정일*

  • 출처
    Int J Colorectal Dis.
  • 등재일
    2020 Dec
  • 저널이슈번호
    35(12):2239-2248. doi: 10.1007/s00384-020-03701-z.
  • 내용

    바로가기  >

    Abstract
    Purpose: This study aimed to identify the risk factors for locoregional recurrence (LR) and determine possible candidates for postoperative concurrent chemoradiotherapy (CCRT) in pathologic T3N0 (pT3N0) rectal cancer patients with a negative resection margin after total mesorectal excision (TME).

    Method: Data from 365 patients who had pT3N0 rectal cancer between 2003 and 2012 in the Samsung Medical Center were reviewed. All patients underwent upfront surgery without preoperative treatment. Postoperative management involved either no adjuvant therapy (n = 122), chemotherapy alone (n = 100), or CCRT (n = 143).

    Results: The median follow-up duration was 71 months. The 5-year overall survival, disease-free survival, and LR-free survival (LRFS) rates were 95.9%, 86.9%, and 96.3%, respectively. When comparing the three groups (surgery alone [n = 122], chemotherapy alone [n = 100], and CCRT [n = 143]), there was no significant difference in LRFS among them (94.0%, 93.4%, and 99.2%, respectively; p = 0.20). However, when patients were stratified by risk factors (distance from anal verge ≤ 5 cm and distal resection margin [DRM] ≤ 2 cm), the 5-year LRFS improved by more than 10% by adding CCRT (98.9% with CCRT vs. 87.4% without CCRT, p = 0.006) in those with more than one risk factor. Postoperative CCRT did not affect the 5-year LRFS (100% with CCRT vs. 99.0% without CCRT, p = 0.66) in patients with no risk factors.

    Conclusion: Postoperative CCRT significantly decreased LR in patients with pT3N0 rectal cancer with a negative resection margin but having a distance from the anal verge ≤ 5 cm or DRM ≤ 2 cm.

     

     

    Affiliations

    Jong Yun Baek  1 , Jeong Il Yu  2 , Hee Chul Park  3 , Doo Ho Choi  1 , Gyu Sang Yoo  1 , Woo Yong Lee  4 , Seong Hyeon Yun  4 , Yong Beom Cho  4 , Yoon Ah Park  4 , Hee Cheol Kim  4 , Heerim Nam  5
    1 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    2 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. jeongil.yu@samsung.com.
    3 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. hee.ro.park@samsung.com.
    4 Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    5 Department of Radiation Oncology, Gangbook Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

  • 키워드
    Local; Radiotherapy; Rectal neoplasm; Recurrence; Risk factors.
  • 덧글달기
    덧글달기
       IP : 18.232.125.188

    등록