K Zwirner1, P Bonomo2, U Lamprecht1, D Zips1,3,4, C Gani1,3,4. 1. a Department of Radiation Oncology , University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen , Tübingen , Germany. 2. b Radiotherapy Unit , Azienda Ospedaliero Universitaria Careggi, University of Florence , Florence , Italy. 3. c Gastrointestinal Cancer Center , Comprehensive Cancer Center Tübingen-Stuttgart , Tübingen , Germany. 4. d German Cancer Consortium (DKTK), partner site Tübingen; and German Cancer Research Center (DKFZ) , Heidelberg , Germany.
Abstract
PURPOSE: To validate a nomogram for the prediction of treatment outcomes after preoperative radiochemotherapy and surgery for locally advanced rectal cancer with a cohort of patients treated with additional deep regional hyperthermia. PATIENTS AND METHODS: A total of 86 patients were treated with preoperative radiochemotherapy and deep regional hyperthermia at our institution. For every patient, the 5-year probability for death, distant metastases and local failure based on a previously published nomogram were calculated and patients were divided into three risk groups. RESULTS: Low-lying and clinically lymph node positive tumours were more frequent in the validation cohort. Five-year Kaplan-Meier estimates for overall survival (OS), distant metastases-free survival (DMFS) and local control (LC) were 87.3%, 79.9%, 95.8% (observed) and 75.5%, 71%, 90% (predicted), respectively. Discrimination between low- and high-risk groups was at a significant level for all endpoints. The c-index was 0.81 (OS), 0.67 (DMFS) and 0.92 (LC), respectively. CONCLUSIONS: The nomogram showed reasonable performance when deep regional hyperthermia is incorporated into preoperative therapy. The higher than predicted rates seen for OS and DMFS in particular in the high-risk groups warrant further prospective validation and subsequent investigation of the underlying mechanisms.
PURPOSE: To validate a nomogram for the prediction of treatment outcomes after preoperative radiochemotherapy and surgery for locally advanced rectal cancer with a cohort of patients treated with additional deep regional hyperthermia. PATIENTS AND METHODS: A total of 86 patients were treated with preoperative radiochemotherapy and deep regional hyperthermia at our institution. For every patient, the 5-year probability for death, distant metastases and local failure based on a previously published nomogram were calculated and patients were divided into three risk groups. RESULTS: Low-lying and clinically lymph node positive tumours were more frequent in the validation cohort. Five-year Kaplan-Meier estimates for overall survival (OS), distant metastases-free survival (DMFS) and local control (LC) were 87.3%, 79.9%, 95.8% (observed) and 75.5%, 71%, 90% (predicted), respectively. Discrimination between low- and high-risk groups was at a significant level for all endpoints. The c-index was 0.81 (OS), 0.67 (DMFS) and 0.92 (LC), respectively. CONCLUSIONS: The nomogram showed reasonable performance when deep regional hyperthermia is incorporated into preoperative therapy. The higher than predicted rates seen for OS and DMFS in particular in the high-risk groups warrant further prospective validation and subsequent investigation of the underlying mechanisms.
Entities:
Keywords:
Predictive model; hyperthermia; nomogram; prognostic factors; radiochemotherapy; rectal cancer
Authors: Baard-Christian Schem; Frank Pfeffer; Martin Anton Ott; Johan N Wiig; Nils Sletteskog; Torbjørn Frøystein; Mette Pernille Myklebust; Sabine Leh; Olav Dahl; Olav Mella Journal: Cancers (Basel) Date: 2022-01-29 Impact factor: 6.639