Journal of Yeungnam Medical Science

Original articles

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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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

Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Tsuyoshi Ozawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara
International Journal of Colorectal Disease.2022; 37(1): 189. CrossRef
Preoperative sarcopenia is a poor prognostic factor in lower rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a retrospective study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Koji Oba, Soichiro Ishihara
International Journal of Clinical Oncology.2022; 27(1): 141. CrossRef
A Four-Methylated lncRNAs-Based Prognostic Signature for Hepatocellular Carcinoma
Le-En Liao, Dan-Dan Hu, Yun Zheng
Genes.2020; 11(8): 908. CrossRef

Clinical significance of lymph node size in locally advanced cervical cancer treated with concurrent chemoradiotherapy: Jinju Oh, Ki Ho Seol, Youn Seok Choi, Jeong Won Lee, Jin Young Bae; Yeungnam Univ J Med. 2019;36(2):115-123. Published online February 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00143

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Abstract PDF

Background
This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT).
Methods
A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed.
Results
The median follow-up period was 83 months (range, 3-201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the in-field para-aortic LN failure rate (p=0.024). The pelvic and para-aortic LN size (≥10 mm) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ≥10 mm).
Conclusion
A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.

Citations

Citations to this article as recorded by

Therapeutic effects of surgical debulking of metastatic lymph nodes in cervical cancer IIICr: a trial protocol for a phase III, multicenter, randomized controlled study (KGOG1047/DEBULK trial)
Bo Seong Yun, Kwang-Beom Lee, Keun Ho Lee, Ha Kyun Chang, Joo-Young Kim, Myong Cheol Lim, Chel Hun Choi, Hanbyoul Cho, Dae-Yeon Kim, Yun Hwan Kim, Joong Sub Choi, Chae Hyeong Lee, Jae-Weon Kim, Sang Wun Kim, Yong Bae Kim, Chi-Heum Cho, Dae Gy Hong, Yong J
Journal of Gynecologic Oncology.2024;[Epub] CrossRef
Can we triumph over locally advanced cervical cancer with colossal para-aortic lymph nodes? A case report
Abdulla Alzibdeh, Issa Mohamad, Lina Wahbeh, Ramiz Abuhijlih, Fawzi Abuhijla
World Journal of Clinical Cases.2024; 12(10): 1851. CrossRef
Efficacy of lymph node dissection on stage IIICr of cervical cancer before CCRT: study protocol for a phase III, randomized controlled clinical trial (CQGOG0103)
Misi He, Mingfang Guo, Qi Zhou, Ying Tang, Lin Zhong, Qing Liu, Xiaomei Fan, Xiwa Zhao, Xiang Zhang, Gang Chen, Yuanming Shen, Qin Xu, Xiaojun Chen, Yuancheng Li, Dongling Zou
Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Stadializarea clinică şi chirurgicală a pacientelor cu cancer de col uterin – studiu retrospectiv privind corelaţiile dintre diagnosticul iniţial, opţiunile de tratament şi rezultatele histopatologice
Mihai-Cristian Dumitraşcu, Adina-Elena Nenciu, Cătălin George Nenciu, Carmen Ursu, Andreea Ilieşiu, Alexandru Baroş, Diana Secară, Monica Mihaela Cîrstoiu
Ginecologia.ro.2023; 1(39): 30. CrossRef
Treatment of bulky lymph nodes in locally advanced cervical cancer: boosting versus debulking
Ester Paulien Olthof, Hans Wenzel, Jacobus van der Velden, Anje M Spijkerboer, Ruud Bekkers, Jogchum J Beltman, Hans W Nijman, Brigitte Slangen, Ramon Smolders, Nienke van Trommel, Petra L M Zusterzeel, Ronald Zweemer, Lukas J A Stalpers, Maaike van der A
International Journal of Gynecologic Cancer.2022; 32(7): 861. CrossRef
Targetability of cervical cancer by magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU)-mediated hyperthermia (HT) for patients receiving radiation therapy
Lifei Zhu, Yi Huang, Dao Lam, H. Michael Gach, Imran Zoberi, Dennis E. Hallahan, Perry W. Grigsby, Hong Chen, Michael B. Altman
International Journal of Hyperthermia.2021; 38(1): 498. CrossRef
Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB–IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study
Simone Marnitz, Audrey Tieko Tsunoda, Peter Martus, Marcelo Vieira, Renato Jose Affonso Junior, João Nunes, Volker Budach, Hermann Hertel, Alexander Mustea, Jalid Sehouli, Jens-Peter Scharf, Uwe Ulrich, Andreas Ebert, Iris Piwonski, Christhardt Kohler
International Journal of Gynecologic Cancer.2020; 30(12): 1855. CrossRef

Review Article

Role of Radiation Therapy in Treatment of Stomach Cancers: Sang Mo Yun, Myung Se Kim; Yeungnam Univ J Med. 2007;24(2 Suppl):S245-251. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S245

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Abstract PDF: Although occasionally used as a therapeutic modality, radiotherapy was not a routine part of the treatment of stomach cancer. As a single modality, preoperative radiotherapy showed some benefit, but this was not confirmed in radomized trial. In recent neoadjuvant trials, radiotherapy is usually given concurrently with chemotherapy, and pathologic complete response rates was about 30%. There were small studies of radiotherapy as an adjuvant, either alone or with chemotherapy, but the randomized studies using postoperative radiotherapy alone did not show a survival benefit. The results of intergroup gastric adjuvant trial(INT 0116) were presented in May 2000 at American Society of Clinical Oncology. In that report, postoperative concurrent chemoradiotherapy showed survival benefit. INT 0116 has established postoperative chemoradiotherapy as the standard care for high risk patients with resected stomach cancer. But, INT 0116 had several weak points including lack of standardized nodal dissection and delivery rates of treatments. So, Asian and European investigators did not agree. Korean study showed benefit of postoperative chemoradiotherapy after D2 dissection, but this study was not randomized. Recently, Korean investigators started randomized trial of chemoradiotherapy in D2 dissected patients. This trial may give answer to us about the benefit of postoperative chemoradiotherapy in resected stomach cancer.

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