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Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy

OBJECTIVE: To investigate prognostic significance of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and total mesorectal excision. PATIENTS AND METHODS: 210 patients with locally advanced rectal carcinoma (cT3-...

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Autores principales: Wen, Bixiu, Zhang, Luning, Wang, Chengtao, Huang, Rong, Peng, Haihua, Zhang, Tian, Dong, Jun, Xiao, Weiwei, Zeng, Zhifan, Liu, Mengzhong, Gao, Yuanhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490617/
https://www.ncbi.nlm.nih.gov/pubmed/26040453
http://dx.doi.org/10.1186/s13014-015-0425-5
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author Wen, Bixiu
Zhang, Luning
Wang, Chengtao
Huang, Rong
Peng, Haihua
Zhang, Tian
Dong, Jun
Xiao, Weiwei
Zeng, Zhifan
Liu, Mengzhong
Gao, Yuanhong
author_facet Wen, Bixiu
Zhang, Luning
Wang, Chengtao
Huang, Rong
Peng, Haihua
Zhang, Tian
Dong, Jun
Xiao, Weiwei
Zeng, Zhifan
Liu, Mengzhong
Gao, Yuanhong
author_sort Wen, Bixiu
collection PubMed
description OBJECTIVE: To investigate prognostic significance of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and total mesorectal excision. PATIENTS AND METHODS: 210 patients with locally advanced rectal carcinoma (cT3-4 or cN+) treated with neo-CRT followed by total mesorectal excision. Treatment outcomes were compared according to clinical and pathological stage. Overall survival (OS), disease free survival (DFS) among patients with different clinical stage and pathological stage after neo-CRT. RESULTS: The median follow-up time was 47 months (range, 14–98 months). Clinical T stage was associated with 5 year OS (p = 0.042) and 5 year DFS (p = 0.014) while clinical N stage was not associated with 5 year OS (p = 0.440), 5 year DFS (p = 0.711). Pathological T stage was associate with 5 year OS (p = 0.001) and 5 year DFS (p = 0.046); and N stage was associated with 5 year OS (p = 0.001), 5 year DFS (p = 0.002). The pathological stage was further classified into three groups: ypT0–2N0 in 91 patients (43.3 %), ypT3–4N0 in 69 patients (32.9 %) and ypT0–4N+ in 50 patients (23.8 %). While pathological stage (ypT0–2 vs ypT3–4N0 vs ypT0–4N+) was associated with 5 year OS (87.9 %, 75.5 %, 56.7 %, p = 0.000), 5 year DFS (74.5 %, 77.4 %, 50.5 %, p = 0.003). Multivariate analysis showed that ypN stage was an independent prognostic factor for patients 5 year DFS. CONCLUSIONS: Pathological stage is strongly associated with treatment outcomes in patients with locally advanced rectal carcinoma treated with neo-CRT followed by total mesorectal excision, which may be used as guidance for further individualized treatment.
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spelling pubmed-44906172015-07-04 Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy Wen, Bixiu Zhang, Luning Wang, Chengtao Huang, Rong Peng, Haihua Zhang, Tian Dong, Jun Xiao, Weiwei Zeng, Zhifan Liu, Mengzhong Gao, Yuanhong Radiat Oncol Research OBJECTIVE: To investigate prognostic significance of clinical and pathological stages in patients with locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy (neo-CRT) and total mesorectal excision. PATIENTS AND METHODS: 210 patients with locally advanced rectal carcinoma (cT3-4 or cN+) treated with neo-CRT followed by total mesorectal excision. Treatment outcomes were compared according to clinical and pathological stage. Overall survival (OS), disease free survival (DFS) among patients with different clinical stage and pathological stage after neo-CRT. RESULTS: The median follow-up time was 47 months (range, 14–98 months). Clinical T stage was associated with 5 year OS (p = 0.042) and 5 year DFS (p = 0.014) while clinical N stage was not associated with 5 year OS (p = 0.440), 5 year DFS (p = 0.711). Pathological T stage was associate with 5 year OS (p = 0.001) and 5 year DFS (p = 0.046); and N stage was associated with 5 year OS (p = 0.001), 5 year DFS (p = 0.002). The pathological stage was further classified into three groups: ypT0–2N0 in 91 patients (43.3 %), ypT3–4N0 in 69 patients (32.9 %) and ypT0–4N+ in 50 patients (23.8 %). While pathological stage (ypT0–2 vs ypT3–4N0 vs ypT0–4N+) was associated with 5 year OS (87.9 %, 75.5 %, 56.7 %, p = 0.000), 5 year DFS (74.5 %, 77.4 %, 50.5 %, p = 0.003). Multivariate analysis showed that ypN stage was an independent prognostic factor for patients 5 year DFS. CONCLUSIONS: Pathological stage is strongly associated with treatment outcomes in patients with locally advanced rectal carcinoma treated with neo-CRT followed by total mesorectal excision, which may be used as guidance for further individualized treatment. BioMed Central 2015-06-04 /pmc/articles/PMC4490617/ /pubmed/26040453 http://dx.doi.org/10.1186/s13014-015-0425-5 Text en © Wen et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Wen, Bixiu
Zhang, Luning
Wang, Chengtao
Huang, Rong
Peng, Haihua
Zhang, Tian
Dong, Jun
Xiao, Weiwei
Zeng, Zhifan
Liu, Mengzhong
Gao, Yuanhong
Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
title Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
title_full Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
title_fullStr Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
title_full_unstemmed Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
title_short Prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
title_sort prognostic significance of clinical and pathological stages on locally advanced rectal carcinoma after neoadjuvant chemoradiotherapy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490617/
https://www.ncbi.nlm.nih.gov/pubmed/26040453
http://dx.doi.org/10.1186/s13014-015-0425-5
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