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The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision

BACKGROUND: Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metas...

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Autores principales: Lai, I-Li, You, Jeng-Fu, Chern, Yih-Jong, Tsai, Wen-Sy, Chiang, Jy-Ming, Hsieh, Pao-Shiu, Hung, Hsin-Yuan, Hsu, Yu-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045195/
https://www.ncbi.nlm.nih.gov/pubmed/33849564
http://dx.doi.org/10.1186/s12957-021-02223-4
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author Lai, I-Li
You, Jeng-Fu
Chern, Yih-Jong
Tsai, Wen-Sy
Chiang, Jy-Ming
Hsieh, Pao-Shiu
Hung, Hsin-Yuan
Hsu, Yu-Jen
author_facet Lai, I-Li
You, Jeng-Fu
Chern, Yih-Jong
Tsai, Wen-Sy
Chiang, Jy-Ming
Hsieh, Pao-Shiu
Hung, Hsin-Yuan
Hsu, Yu-Jen
author_sort Lai, I-Li
collection PubMed
description BACKGROUND: Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metastasis separately. METHODS: This retrospective, single-center study comprised of 279 consecutive patients from Linkou branch of Chang Gung Memorial Hospital in 2005–2016 with rectal adenocarcinoma, pT1/T2N0M0 at distance from anal verge ≤ 8cm, who received curative radical resection. RESULTS: The study included 279 patients with pT1/pT2N0 mid-low rectal cancer with median follow-up of 73.5 months. Nineteen (6.8%) patients had disease recurrence in total. Nine (3.2%) of them had local recurrence, and fourteen (5.0%) of them had distant metastasis. Distal resection margin < 0.9 (cm) (hazard ratio = 4.9, p = 0.050) was the risk factor of local recurrence. Preoperative carcinoembryonic antigen (CEA) ≥ 5 ng/mL (hazard ratio = 9.3, p = 0.0003), lymph node yield (LNY) < 14 (hazard ratio = 5.0, p = 0.006), and distal resection margin < 1.4cm (hazard ratio = 4.0, p = 0.035) were the risk factors of distant metastasis. CONCLUSION: For patients with pT1/pT2N0 mid-low rectal cancer, current multidisciplinary treatment brings acceptable survival outcome. Insufficient distal resection margin attracted the awareness of risk factors for local recurrence and distant metastasis as a foundation for future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-021-02223-4.
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spelling pubmed-80451952021-04-14 The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision Lai, I-Li You, Jeng-Fu Chern, Yih-Jong Tsai, Wen-Sy Chiang, Jy-Ming Hsieh, Pao-Shiu Hung, Hsin-Yuan Hsu, Yu-Jen World J Surg Oncol Research BACKGROUND: Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metastasis separately. METHODS: This retrospective, single-center study comprised of 279 consecutive patients from Linkou branch of Chang Gung Memorial Hospital in 2005–2016 with rectal adenocarcinoma, pT1/T2N0M0 at distance from anal verge ≤ 8cm, who received curative radical resection. RESULTS: The study included 279 patients with pT1/pT2N0 mid-low rectal cancer with median follow-up of 73.5 months. Nineteen (6.8%) patients had disease recurrence in total. Nine (3.2%) of them had local recurrence, and fourteen (5.0%) of them had distant metastasis. Distal resection margin < 0.9 (cm) (hazard ratio = 4.9, p = 0.050) was the risk factor of local recurrence. Preoperative carcinoembryonic antigen (CEA) ≥ 5 ng/mL (hazard ratio = 9.3, p = 0.0003), lymph node yield (LNY) < 14 (hazard ratio = 5.0, p = 0.006), and distal resection margin < 1.4cm (hazard ratio = 4.0, p = 0.035) were the risk factors of distant metastasis. CONCLUSION: For patients with pT1/pT2N0 mid-low rectal cancer, current multidisciplinary treatment brings acceptable survival outcome. Insufficient distal resection margin attracted the awareness of risk factors for local recurrence and distant metastasis as a foundation for future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12957-021-02223-4. BioMed Central 2021-04-13 /pmc/articles/PMC8045195/ /pubmed/33849564 http://dx.doi.org/10.1186/s12957-021-02223-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Lai, I-Li
You, Jeng-Fu
Chern, Yih-Jong
Tsai, Wen-Sy
Chiang, Jy-Ming
Hsieh, Pao-Shiu
Hung, Hsin-Yuan
Hsu, Yu-Jen
The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
title The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
title_full The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
title_fullStr The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
title_full_unstemmed The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
title_short The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision
title_sort risk factors of local recurrence and distant metastasis on pt1/t2n0 mid-low rectal cancer after total mesorectal excision
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045195/
https://www.ncbi.nlm.nih.gov/pubmed/33849564
http://dx.doi.org/10.1186/s12957-021-02223-4
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