BACKGROUND AND PURPOSE: This study was undertaken to investigate down-staging effects after short-term, high-fractionated preoperative radiotherapy. MATERIAL AND METHODS: The relationships between preoperative radiotherapy 25-25.5 Gy given over 5-7 days and clinical variables (sex, age, tumour level, metastatic disease, and tumour size) and the risk of lymph node metastases were examined in 1316 patients with rectal adenocarcinoma by uni-, and multivariate analyses. RESULTS: Irradiated specimens contained smaller tumours (P < 0.00001) and nodal metastases were less common (P < 0.001). In a logistic regression model, tumour size in cm was positively related to the risk for nodal spread (odds ratio, OR = 1.14, 95% confidence limits, CL, of OR 1.08-1.22). In the same model, radiotherapy decreased the risk for nodal involvement (OR 0.73, 95% CL 0.58-0.92. This risk was particularly reduced when the time interval between start of radiotherapy and surgery equalled 10 days or more. CONCLUSIONS: These results demonstrate a down-staging effect by a short course of preoperative radiotherapy which should be considered in the interpretation of radiotherapy trials and in the recruitment of patients for further postoperative adjuvant treatment.
RCT Entities:
BACKGROUND AND PURPOSE: This study was undertaken to investigate down-staging effects after short-term, high-fractionated preoperative radiotherapy. MATERIAL AND METHODS: The relationships between preoperative radiotherapy 25-25.5 Gy given over 5-7 days and clinical variables (sex, age, tumour level, metastatic disease, and tumour size) and the risk of lymph node metastases were examined in 1316 patients with rectal adenocarcinoma by uni-, and multivariate analyses. RESULTS: Irradiated specimens contained smaller tumours (P < 0.00001) and nodal metastases were less common (P < 0.001). In a logistic regression model, tumour size in cm was positively related to the risk for nodal spread (odds ratio, OR = 1.14, 95% confidence limits, CL, of OR 1.08-1.22). In the same model, radiotherapy decreased the risk for nodal involvement (OR 0.73, 95% CL 0.58-0.92. This risk was particularly reduced when the time interval between start of radiotherapy and surgery equalled 10 days or more. CONCLUSIONS: These results demonstrate a down-staging effect by a short course of preoperative radiotherapy which should be considered in the interpretation of radiotherapy trials and in the recruitment of patients for further postoperative adjuvant treatment.
Authors: Bianca W Chang; Aryavarta M S Kumar; Shlomo A Koyfman; Matthew Kalady; Ian Lavery; May Abdel-Wahab Journal: Int J Colorectal Dis Date: 2015-01-08 Impact factor: 2.571
Authors: Anna Margherita Maffione; Alice Ferretti; Gaia Grassetto; Elena Bellan; Carlo Capirci; Sotirios Chondrogiannis; Marcello Gava; Maria Cristina Marzola; Lucia Rampin; Claudia Bondesan; Patrick M Colletti; Domenico Rubello Journal: Eur J Nucl Med Mol Imaging Date: 2013-02-16 Impact factor: 9.236
Authors: Leyo Ruo; Satish Tickoo; David S Klimstra; Bruce D Minsky; Leonard Saltz; Madhu Mazumdar; Philip B Paty; W Douglas Wong; Steven M Larson; Alfred M Cohen; Jose G Guillem Journal: Ann Surg Date: 2002-07 Impact factor: 12.969