Early Systemic Failure After Preoperative Chemoradiotherapy for the Treatment of Patients With Rectal Cancer
Annals of Coloproctology
;
: 94-99, 2019.
Article
in English
| WPRIM
| ID: wpr-762299
ABSTRACT
PURPOSE:
Distant metastasis can occur early after neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. This study was conducted to evaluate the clinical characteristics of patients who developed early systemic failure.METHODS:
The patients who underwent neoadjuvant CRT for a rectal adenocarcinoma between June 2007 and July 2015 were included in this study. Patients who developed distant metastasis within 6 months after CRT were identified. We compared short- and long-term clinicopathologic outcomes of patients in the early failure (EF) group with those of patients in the control group.RESULTS:
Of 107 patients who underwent neoadjuvant CRT for rectal cancer, 7 developed early systemic failure. The lung was the most common metastatic site. In the EF group, preoperative carcinoembryonic antigen was higher (5 mg/mL vs. 2 mg/mL, P = 0.010), and capecitabine as a sensitizer of CRT was used more frequently (28.6% vs. 3%, P = 0.002). Of the 7 patients in the EF group, only 4 underwent a primary tumor resection (57.1%), in contrast to the 100% resection rate in the control group (P < 0.001). In terms of pathologic outcomes, ypN and TNM stages were more advanced in the EF group (P < 0.001 and P = 0.047, respectively), and numbers of positive and retrieved lymph nodes were much higher (P < 0.001 and P = 0.027, respectively).CONCLUSION:
Although early distant metastasis after CRT for rectal cancer is very rare, patients who developed early metastasis showed a poor nodal response with a low primary tumor resection rate and poor oncologic outcomes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Rectal Neoplasms
/
Adenocarcinoma
/
Carcinoembryonic Antigen
/
Neoadjuvant Therapy
/
Chemoradiotherapy
/
Capecitabine
/
Lung
/
Lymph Nodes
/
Neoplasm Metastasis
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Annals of Coloproctology
Year:
2019
Type:
Article
Similar
MEDLINE
...
LILACS
LIS