Evaluation of treatment response and tissue necrosis as prognostic indicators following neoadjuvant chemoradiotherapy in rectal cancer patients
The Korean Journal of Internal Medicine
;
: 134-144, 2016.
Article
in English
| WPRIM
| ID: wpr-220493
ABSTRACT
BACKGROUND/AIMS:
The objective of this study was to assess the prognostic roles of treatment response and tissue necrosis after chemoradiotherapy (CRT) in locally advanced rectal cancer.METHODS:
A total of 243 patients with locally advanced rectal cancer who underwent neoadjuvant CRT were included. Three treatment response groups were classified by their pathological stageresults:
complete treatment response (CTR), intermediate treatment response (ITR), and poor treatment response (PTR). Three tissue necrosis groups were classified based on tissue pathologicalresults:
complete necrosis response (CNR), intermediate necrosis response (INR), and poor necrosis response (PNR).RESULTS:
Overall survival (OS) and recurrence-free survival (RFS) rate at three years were 74.5% and 61.3%, respectively. The 3-year OS rates of the CTR, ITR, and PTR groups were 83.7%, 75.9%, and 69.7%, respectively (p < 0.001); the 3-year RFS rates were 76.7%, 69.0%, and 52.1%, respectively (p < 0.001). The 3-year OS rates of the CNR, INR, and PNR groups were 83.7%, 80.6%, and 61.8%, respectively (p < 0.001); the 3-year RFS rates were 76.7%, 68.9%, and 44.3%, respectively (p < 0.001). When compared to CTR/CNR, PTR/PNR was strongly related to an increased risk of recurrence (hazard ratio [HR], 5.53; 95% confidence interval [CI], 2.01 to 15.23 vs. HR, 6.37; 95% CI, 2.29 to 17.74, respectively) in univariate Cox regression. Both PTR and PNR were strongly associated with shorter RFS and OS when compared with CTR and CNR in the multivariate Cox regression.CONCLUSIONS:
Tissue necrosis is an equally important prognostic marker as treatment response for oncologic outcomes in locally advanced rectal cancer.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Rectal Neoplasms
/
Time Factors
/
Biopsy
/
Remission Induction
/
Chi-Square Distribution
/
Proportional Hazards Models
/
Multivariate Analysis
/
Retrospective Studies
/
Risk Factors
/
Treatment Outcome
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2016
Type:
Article
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