STAGE-TO-STAGE COMPARISON OF PREOPERATIVE AND POSTOPERATIVE CHEMORADIOTHERAPY FOR T3 MID OR DISTAL RECTAL CANCER
- Authors
- Yeo, Seung-Gu; Kim, Dae Yong; Park, Ji Won; Choi, Hyo Seong; Oh, Jae Hwan; Kim, Sun Young; Chang, Hee Jin; Kim, Tae Hyun; Sohn, Dae Kyung
- Issue Date
- 1-Feb-2012
- Publisher
- Elsevier BV
- Keywords
- ypStage; pStage; Rectal cancer; Chemoradiotherapy; Downstaging
- Citation
- International Journal of Radiation Oncology Biology Physics, v.82, no.2, pp 856 - 862
- Pages
- 7
- Journal Title
- International Journal of Radiation Oncology Biology Physics
- Volume
- 82
- Number
- 2
- Start Page
- 856
- End Page
- 862
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/15361
- DOI
- 10.1016/j.ijrobp.2010.10.079
- ISSN
- 0360-3016
1879-355X
- Abstract
- Purpose: To investigate, in a comparative analysis, the prognostic implications of postchemoradiotherapy (post-CRT) pathologic stage (ypStage) vs. postoperative pathologic stage (pStage) in rectal cancer. Methods and Materials: Between May 2001 and December 2006, 487 patients with T3 mid or distal rectal cancer were analyzed retrospectively. Concurrent CRT was administered preoperatively (n = 364, 74.7%) or postoperatively (n = 123, 25.3%). The radiation dose was 50.4 Gy in 28 fractions. All patients underwent a total mesorectal excision and received adjuvant chemotherapy. Disease-free survival (DES) was estimated using the Kaplan-Meier method. Differences in DFS, stratified by ypStage and pStage, were compared using the log rank test. Results: For surviving patients, the median follow-up period was 68 months (range, 12-105 months). The 5-year local recurrence-free survival rate was not different, at 95.3% and 92.1% in preoperative and postoperative CRT groups, respectively (p = 0.402), but the 5-year distant metastasis-free survival rate was significantly different, at 81.6% (preoperative CRT) vs. 65.4% (postoperative CRT; p = 0.001). The 5-year DFS rate of 78.8% in the preoperative CRT group was significantly better than the 63.0% rate in the postoperative CRT group (p = 0.002). Post-CRT pathologic Stage 0-I occurred in 42.6% (155 of 364) of the patients with preoperative CRT. The 5 year DFS rates were 90.2% (ypStage 0-I), 83.5% (ypStage II), 77.3% (pStage H), 58.6% (ypStage HI), and 54.7% (pStage III). The DES rate of ypStage 0-I was significantly better than that of ypStage H or pStage II. Post-CRT pathologic Stage H and III had similar DFS, compared with pStage II and III, respectively. Conclusions: Disease-free survival predicted by each ypStage was similar to that predicted by the respective pStage. Improved DFS with preoperative vs. postoperative CRT was associated with the ypStage 0 I group that showed a similarly favorable outcome to pStage I rectal cancer. (C) 2012 Elsevier Inc.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Radiation Oncology > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/15361)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.