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JYMS : Journal of Yeungnam Medical Science

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An Na Seo 1 Article
What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?
Sol-Min Kim, Ghilsuk Yoon, An Na Seo
Yeungnam Univ J Med. 2019;36(2):124-135.   Published online April 1, 2019
DOI: https://doi.org/10.12701/yujm.2019.00157
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AbstractAbstract PDF
Background
We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods
Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results
The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS, irrespective of subgrouping according to downstage (non-downstage, p=0.001; downstage, p=0.010) or lymph node metastasis (non-metastasis, p=0.004; metastasis, p=0.007).
Conclusion
CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

Citations

Citations to this article as recorded by  
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    International Journal of Colorectal Disease.2022; 37(1): 189.     CrossRef
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    International Journal of Clinical Oncology.2022; 27(1): 141.     CrossRef
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JYMS : Journal of Yeungnam Medical Science