Atsushi Ogura1,2, Takashi Akiyoshi3, Noriko Yamamoto4, Hiroshi Kawachi4, Yuichi Ishikawa4, Hisashi Noma5, Masato Nagino2, Yosuke Fukunaga1, Masashi Ueno1. 1. Department of Gastroenterological Surgery, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan. 2. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 3. Department of Gastroenterological Surgery, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan. takashi.akiyoshi@jfcr.or.jp. 4. Division of Pathology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan. 5. Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan.
Abstract
PURPOSE: The prognostic significance of the depth of mesorectal invasion (DMI) in patients with ypT3 rectal cancer who undergo preoperative chemoradiotherapy (CRT) is unclear. The purpose of this study was to evaluate the prognostic significance of DMI in ypT3 rectal cancer. METHODS: A total of 168 (y)pT3 patients were evaluated, of whom 93 received preoperative CRT and 75 underwent surgery alone. Patients were subdivided into two groups according to the DMI (T3ab = DMI ≤5 mm and T3cd = DMI >5 mm). Oncologic outcomes were compared between the T3ab and T3cd groups and the ypT3ab and ypT3cd groups. RESULTS: Relapse-free survival was significantly different between the pT3ab and pT3cd groups (74.1 vs 38.5%, P = 0.0192) but not between the ypT3ab and ypT3cd groups (65.9 vs 61.5%, P = 0.513). Multivariate analysis showed that DMI was an independent predictor of recurrence in pT3 patients (hazard ratio [HR] = 2.980, 95% confidence interval [CI] 1.227-7.025; P = 0.0169) and that ypN+ was an independent predictor of recurrence in ypT3 patients (HR = 3.487, 95% CI 1.570-8.827; P = 0.0016). CONCLUSIONS: DMI was not a significant predictive factor for recurrence in patients with ypT3 rectal cancer who underwent preoperative CRT, and ypN+ was the only independent predictive factor for recurrence.
PURPOSE: The prognostic significance of the depth of mesorectal invasion (DMI) in patients with ypT3 rectal cancer who undergo preoperative chemoradiotherapy (CRT) is unclear. The purpose of this study was to evaluate the prognostic significance of DMI in ypT3 rectal cancer. METHODS: A total of 168 (y)pT3 patients were evaluated, of whom 93 received preoperative CRT and 75 underwent surgery alone. Patients were subdivided into two groups according to the DMI (T3ab = DMI ≤5 mm and T3cd = DMI >5 mm). Oncologic outcomes were compared between the T3ab and T3cd groups and the ypT3ab and ypT3cd groups. RESULTS: Relapse-free survival was significantly different between the pT3ab and pT3cd groups (74.1 vs 38.5%, P = 0.0192) but not between the ypT3ab and ypT3cd groups (65.9 vs 61.5%, P = 0.513). Multivariate analysis showed that DMI was an independent predictor of recurrence in pT3 patients (hazard ratio [HR] = 2.980, 95% confidence interval [CI] 1.227-7.025; P = 0.0169) and that ypN+ was an independent predictor of recurrence in ypT3 patients (HR = 3.487, 95% CI 1.570-8.827; P = 0.0016). CONCLUSIONS:DMI was not a significant predictive factor for recurrence in patients with ypT3 rectal cancer who underwent preoperative CRT, and ypN+ was the only independent predictive factor for recurrence.
Entities:
Keywords:
Chemoradiotherapy; Depth of mesorectal invasion; Rectal cancer; ypT3
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