Claudio V Sole1, Felipe A Calvo2, Javier Serrano3, Emilio Del Valle4, Marcos Rodriguez4, Alberto Muñoz-Calero5, Fernando Turégano4, Jose Luis García-Sabrido5, Pilar Garcia-Alfonso6, Isabel Peligros7, Sofia Rivera8, Eric Deutsch8, Emilio Alvarez9. 1. Department of Radiation Oncology, Instituto de Radiomedicina, Santiago, Chile; Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address: cvsole@uc.cl. 2. Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; School of Medicine, Complutense University, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 3. School of Medicine, Complutense University, Madrid, Spain; Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 4. Department of Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 5. School of Medicine, Complutense University, Madrid, Spain; Department of Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 6. School of Medicine, Complutense University, Madrid, Spain; Service of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 7. Department of Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 8. Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France; Molecular Radiotherapy Laboratory INSERM1030, Gustave Roussy Cancer Campus, Villejuif, France; School of Medicine, Paris-Sud University, Villejuif, France. 9. School of Medicine, Complutense University, Madrid, Spain; Department of Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigacion Sanitaria, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Abstract
BACKGROUND: Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT. METHODS: A total of 335 patients with LARC [⩾cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed. RESULTS: Median follow-up was 72.6 months (range, 4-205). In multivariate analysis distal margin distance ⩽10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1-2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC. CONCLUSIONS: Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.
BACKGROUND:Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT. METHODS: A total of 335 patients with LARC [⩾cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed. RESULTS: Median follow-up was 72.6 months (range, 4-205). In multivariate analysis distal margin distance ⩽10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1-2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC. CONCLUSIONS: Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.
Authors: Felipe Ángel Calvo Manuel; Javier Serrano; Claudio Solé; Mauricio Cambeiro; Jacobo Palma; Javier Aristu; Jose Luis Garcia-Sabrido; Miguel Angel Cuesta; Emilio Del Valle; Fernando Lapuente; Bernardino Miñana; Miguel Ángel Morcillo; Jose Manuel Asencio; Javier Pascau Journal: Clin Transl Oncol Date: 2022-09-28 Impact factor: 3.340
Authors: Felipe A Calvo; Claudio V Sole; Harm J Rutten; Wim J Dries; Miguel A Lozano; Mauricio Cambeiro; Philip Poortmans; Luis González-Bayón Journal: Clin Transl Radiat Oncol Date: 2020-06-17