Five-year oncologic outcomes and prognostic factors for locally advanced low rectal cancer after low anterior resection
Objective: The aim of the study is to investigate the longterm oncologic outcomes including local recurrence, distant metastases and overall survival (OS) for patients with low rectal cancer underwent low anterior resection (LAR) with total mesorectal excision (TME), and to analyze the prognostic fa...
Saved in:
Published in | 中德临床肿瘤学杂志(英文版) no. 7; pp. 309 - 315 |
---|---|
Main Author | |
Format | Journal Article |
Language | English |
Published |
Department of Radiation 0ncology, The Military General Hospital of Beijing PLA, Beijing 100700, China
2014
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Objective: The aim of the study is to investigate the longterm oncologic outcomes including local recurrence, distant metastases and overall survival (OS) for patients with low rectal cancer underwent low anterior resection (LAR) with total mesorectal excision (TME), and to analyze the prognostic factors for them. Methods: Between January 2001 and December 2009, 147 patients with clinical stage II and III rectal cancers located 3-6 cm from the anal verge underwent LAR with TME without temporary diverting stoma. The median distal resection margin (DRM) was 1.0 (range, 0.3-5) cm. Anastomostic leakage occurred in 29 (19.7%) patients. Thirty patients received surgery alone, 20 patients received preoperative chemoradiotherapy (CRT), 43 patients received postoperative CRT, and adjuvant chemotherapy was administered for 108 patients. The median cycle of adjuvant chemotherapy was 6 (range, 2-20) cycles. The median followup was 74.8 (range, 30.1-146.3) months. Results: In all patients, 5-year recurrence-free survival (RFS), disease-free survival (DFS) and OS were 70.4%, 54.2% and 60.5%, respectively. Forty-three (29.3%) patients suffered local recurrence. Patients received preoperative CRT with a downstaging yp0/1 who had a better 5-year RFS, DFS and OS, which were 100%, 90.9%, and 90.9%, respectively. For patients with pathologic stage Ⅱ and stage Ⅲ, the 5-year RFS, DFS, and OS were 79.2% and 60.1%, 67.9% and 39.1%, 72.1% and 48.2%, respectively. On multivariable analysis, RFS was associated with anostomostic leakage, DFS was associated with anastomostic leakage and pathologic N stage, and OS was associated with anastomostic leakage, pathologic N and T stage. For patients with anastomostic leakage, the 5-year RFS, DFS, and OS were 51.7%, 32.4%, and 38.3%, respectively, which were worse than that for patients without anastomostic leakage, the latter were 75.2%, 59.7%, 65.7%, respectively (P 〈 0.05). DRM and radiotherapy were associated with RFS on univariable analysis (P 〈 0.05), but not on multivariable analysis. Tumor grade was prognostic factors for RFS and OS on univariable analysis, but not on multivariable analysis. The other factors including sex, age, tumor size and adjuvant chemotherapy were not associated with RFS, DFS and OS on univariable analysis. Conclusion: For patients with low rectal caner underwent LAR and TME, the long-term oncologic outcomes were satisfactory for patients with stage yp0/1, but not for patients with pathologic stage II1. Anastomositic leakage negatively affect long-term oncologic outcomes. Radiotherpy, adjuvant chemotherapy and distal resection margin were not associated with long-term outcomes. |
---|---|
AbstractList | The aim of the study is to investigate the long- term oncologic outcomes including local recurrence, distant metastases and overal survival (OS) for patients with low rectal cancer underwent low anterior resection (LAR) with total mesorectal excision (TME), and to analyze the prognostic factors for them. Methods: Between January 2001 and December 2009, 147 patients with clinical stage II and III rectal cancers located 3-6 cm from the anal verge underwent LAR with TME without temporary diverting stoma. The median distal resection margin (DRM) was 1.0 (range, 0.3-5) cm. Anas-tomostic leakage occurred in 29 (19.7%) patients. Thirty patients received surgery alone, 20 patients received preoperative chemoradiotherapy (CRT), 43 patients received postoperative CRT, and adjuvant chemotherapy was administered for 108 patients. The median cycle of adjuvant chemotherapy was 6 (range, 2-20) cycles. The median folow- up was 74.8 (range, 30.1-146.3) months.Results:In al patients, 5-year recurrence-free survival (RFS), disease-free survival (DFS) and OS were 70.4%, 54.2% and 60.5%, respectively. Forty-three (29.3%) patients sufered local recurrence. Patients received preoperative CRT with a downstaging yp0/I who had a better 5-year RFS, DFS and OS, which were 100%, 90.9%, and 90.9%, respectively. For patients with pathologic stage II and stage III, the 5-year RFS, DFS, and OS were 79.2% and 60.1%, 67.9% and 39.1%, 72.1% and 48.2%, respectively. On multivariable analysis, RFS was associated with anostomostic leakage, DFS was associ-ated with anastomostic leakage and pathologic N stage, and OS was associated with anastomostic leakage, pathologic N and T stage. For patients with anastomostic leakage, the 5-year RFS, DFS, and OS were 51.7%, 32.4%, and 38.3%, respectively, which were worse than that for patients without anastomostic leakage, the latter were 75.2%, 59.7%, 65.7%, respectively (P <0.05). DRM and radiotherapy were associated with RFS on univariable analysis (P < 0.05), but not on multivariable analysis. Tumor grade was prognostic factors for RFS and OS on univariable analysis, but not on multivariable analysis. The other factors including sex, age, tumor size and adjuvant chemotherapy were not associated with RFS, DFS and OS on univariable analysis.Conclusion: For patients with low rectal caner underwent LAR and TME, the long-term oncologic outcomes were satisfactory for patients with stage yp0/I, but not for patients with pathologic stage III. Anastomositic leakage negatively afect long-term oncologic outcomes. Radiotherpy, adjuvant chemotherapy and distal resection margin were not associated with long-term outcomes. Objective: The aim of the study is to investigate the longterm oncologic outcomes including local recurrence, distant metastases and overall survival (OS) for patients with low rectal cancer underwent low anterior resection (LAR) with total mesorectal excision (TME), and to analyze the prognostic factors for them. Methods: Between January 2001 and December 2009, 147 patients with clinical stage II and III rectal cancers located 3-6 cm from the anal verge underwent LAR with TME without temporary diverting stoma. The median distal resection margin (DRM) was 1.0 (range, 0.3-5) cm. Anastomostic leakage occurred in 29 (19.7%) patients. Thirty patients received surgery alone, 20 patients received preoperative chemoradiotherapy (CRT), 43 patients received postoperative CRT, and adjuvant chemotherapy was administered for 108 patients. The median cycle of adjuvant chemotherapy was 6 (range, 2-20) cycles. The median followup was 74.8 (range, 30.1-146.3) months. Results: In all patients, 5-year recurrence-free survival (RFS), disease-free survival (DFS) and OS were 70.4%, 54.2% and 60.5%, respectively. Forty-three (29.3%) patients suffered local recurrence. Patients received preoperative CRT with a downstaging yp0/1 who had a better 5-year RFS, DFS and OS, which were 100%, 90.9%, and 90.9%, respectively. For patients with pathologic stage Ⅱ and stage Ⅲ, the 5-year RFS, DFS, and OS were 79.2% and 60.1%, 67.9% and 39.1%, 72.1% and 48.2%, respectively. On multivariable analysis, RFS was associated with anostomostic leakage, DFS was associated with anastomostic leakage and pathologic N stage, and OS was associated with anastomostic leakage, pathologic N and T stage. For patients with anastomostic leakage, the 5-year RFS, DFS, and OS were 51.7%, 32.4%, and 38.3%, respectively, which were worse than that for patients without anastomostic leakage, the latter were 75.2%, 59.7%, 65.7%, respectively (P 〈 0.05). DRM and radiotherapy were associated with RFS on univariable analysis (P 〈 0.05), but not on multivariable analysis. Tumor grade was prognostic factors for RFS and OS on univariable analysis, but not on multivariable analysis. The other factors including sex, age, tumor size and adjuvant chemotherapy were not associated with RFS, DFS and OS on univariable analysis. Conclusion: For patients with low rectal caner underwent LAR and TME, the long-term oncologic outcomes were satisfactory for patients with stage yp0/1, but not for patients with pathologic stage II1. Anastomositic leakage negatively affect long-term oncologic outcomes. Radiotherpy, adjuvant chemotherapy and distal resection margin were not associated with long-term outcomes. |
Author | Bo Yao Yadi Wang Na Lu |
AuthorAffiliation | Department of Radiation Oncology, The Military General Hospital of Beijing PLA, Beijing 100700, China |
AuthorAffiliation_xml | – name: Department of Radiation 0ncology, The Military General Hospital of Beijing PLA, Beijing 100700, China |
Author_xml | – sequence: 1 fullname: Bo Yao Yadi Wang Na Lu |
BookMark | eNotkMFKAzEQhoNUsK0-gLcgeIwmm93N5ijFqlDw0nuZTpJ1yzapyba1b29sPc3Pxzcz8E_IyAdvCbkX_Elwrp6T4FJyxkXJhJSCFVdkLGohmeaNHp0zZ0IrfUMmKW04L3SjmzE5zruDZScLkQaPoQ9thzTsBwxbmyh4Q3cxtD6kIXMHOISYqAuR9gGh708UzAE8WpPBkUaLA_QU_0ik4AYbzxx8Tl3eijZlpQv-llw76JO9-59Tspy_LmfvbPH59jF7WTCslGQWUdm6Kps1R2OkqCyWhXKI1RkKp1WjKw4CLG8KJ40tAbmoENdCaDBySh4vZ4_gHfh2tQn76PPDlWlPP0Wuiyuem5uSh4uHX8G33102d7HbQjyt6looVZa6kr8qXW7Y |
ContentType | Journal Article |
Copyright | Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
Copyright_xml | – notice: Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
DBID | 2RA 92L CQIGP W91 ~WA 2B. 4A8 92I 93N PSX TCJ |
DOI | 10.1007/s10330-014-1331-2 |
DatabaseName | 维普_期刊 中文科技期刊数据库-CALIS站点 维普中文期刊数据库 中文科技期刊数据库-医药卫生 中文科技期刊数据库- 镜像站点 Wanfang Data Journals - Hong Kong WANFANG Data Centre Wanfang Data Journals 万方数据期刊 - 香港版 China Online Journals (COJ) China Online Journals (COJ) |
DatabaseTitleList | |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
DocumentTitleAlternate | Five-year oncologic outcomes and prognostic factors for locally advanced low rectal cancer after low anterior resection |
EISSN | 1613-9089 |
EndPage | 315 |
ExternalDocumentID | dgyx201407003 661774495 |
GroupedDBID | --- -5E -5G -BR -Y2 .86 0R~ 123 29B 2JY 2P1 2RA 2VQ 2~H 30V 4.4 408 409 5VS 6NX 875 8UJ 92L 95. 95~ AAIAL AARHV ABJNI ABMNI ABTEG ACGFS ACOMO ADINQ ADKPE ADQRH ADRFC AFLOW AFNRJ AGJBK AHBYD AHSBF ALMA_UNASSIGNED_HOLDINGS AMKLP ASPBG AVWKF AZFZN BA0 BGNMA CAG COF CQIGP CS3 CSCUP CW9 DL5 EBS EJD EN4 FEDTE GQ6 GQ8 GXS HF~ HG6 HLICF HMJXF HVGLF HZ~ IHE IZIGR I~X KDC KOV KPH LAS M4Y MA- NU0 O9- O93 O9I OAM P9S QOS R9I ROL RPX RSV S.. S1Z S27 S37 S3B SCL SDH SMD SOJ SZN T13 TSK TT1 TUC U2A VC2 W91 WJK WK8 ~A9 ~WA 2B. 4A8 92I 93N PSX TCJ |
ID | FETCH-LOGICAL-c573-ecc7e6548b0cdd315ec427fcc56548b1f978950a1ae082f3de4ac015ccb119ad3 |
ISSN | 1610-1979 |
IngestDate | Tue Feb 13 23:45:48 EST 2024 Wed Feb 14 10:37:47 EST 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 7 |
Keywords | sphincter-preserving surgery prognostic factors low rectal cancer long-term outcomes |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c573-ecc7e6548b0cdd315ec427fcc56548b1f978950a1ae082f3de4ac015ccb119ad3 |
Notes | low rectal cancer; sphincter-preserving surgery; long-term outcomes; prognostic factors Objective: The aim of the study is to investigate the longterm oncologic outcomes including local recurrence, distant metastases and overall survival (OS) for patients with low rectal cancer underwent low anterior resection (LAR) with total mesorectal excision (TME), and to analyze the prognostic factors for them. Methods: Between January 2001 and December 2009, 147 patients with clinical stage II and III rectal cancers located 3-6 cm from the anal verge underwent LAR with TME without temporary diverting stoma. The median distal resection margin (DRM) was 1.0 (range, 0.3-5) cm. Anastomostic leakage occurred in 29 (19.7%) patients. Thirty patients received surgery alone, 20 patients received preoperative chemoradiotherapy (CRT), 43 patients received postoperative CRT, and adjuvant chemotherapy was administered for 108 patients. The median cycle of adjuvant chemotherapy was 6 (range, 2-20) cycles. The median followup was 74.8 (range, 30.1-146.3) months. Results: In all patients, 5-year recurrence-free survival (RFS), disease-free survival (DFS) and OS were 70.4%, 54.2% and 60.5%, respectively. Forty-three (29.3%) patients suffered local recurrence. Patients received preoperative CRT with a downstaging yp0/1 who had a better 5-year RFS, DFS and OS, which were 100%, 90.9%, and 90.9%, respectively. For patients with pathologic stage Ⅱ and stage Ⅲ, the 5-year RFS, DFS, and OS were 79.2% and 60.1%, 67.9% and 39.1%, 72.1% and 48.2%, respectively. On multivariable analysis, RFS was associated with anostomostic leakage, DFS was associated with anastomostic leakage and pathologic N stage, and OS was associated with anastomostic leakage, pathologic N and T stage. For patients with anastomostic leakage, the 5-year RFS, DFS, and OS were 51.7%, 32.4%, and 38.3%, respectively, which were worse than that for patients without anastomostic leakage, the latter were 75.2%, 59.7%, 65.7%, respectively (P 〈 0.05). DRM and radiotherapy were associated with RFS on univariable analysis (P 〈 0.05), but not on multivariable analysis. Tumor grade was prognostic factors for RFS and OS on univariable analysis, but not on multivariable analysis. The other factors including sex, age, tumor size and adjuvant chemotherapy were not associated with RFS, DFS and OS on univariable analysis. Conclusion: For patients with low rectal caner underwent LAR and TME, the long-term oncologic outcomes were satisfactory for patients with stage yp0/1, but not for patients with pathologic stage II1. Anastomositic leakage negatively affect long-term oncologic outcomes. Radiotherpy, adjuvant chemotherapy and distal resection margin were not associated with long-term outcomes. 42-1654/R |
PageCount | 7 |
ParticipantIDs | wanfang_journals_dgyx201407003 chongqing_primary_661774495 |
PublicationCentury | 2000 |
PublicationDate | 2014 |
PublicationDateYYYYMMDD | 2014-01-01 |
PublicationDate_xml | – year: 2014 text: 2014 |
PublicationDecade | 2010 |
PublicationTitle | 中德临床肿瘤学杂志(英文版) |
PublicationTitleAlternate | The Chinese-German Journal of Clinical Oncology |
PublicationTitle_FL | Chinese-German Journal of Clinical Oncology |
PublicationYear | 2014 |
Publisher | Department of Radiation 0ncology, The Military General Hospital of Beijing PLA, Beijing 100700, China |
Publisher_xml | – name: Department of Radiation 0ncology, The Military General Hospital of Beijing PLA, Beijing 100700, China |
SSID | ssj0029898 |
Score | 1.9301598 |
Snippet | Objective: The aim of the study is to investigate the longterm oncologic outcomes including local recurrence, distant metastases and overall survival (OS) for... The aim of the study is to investigate the long- term oncologic outcomes including local recurrence, distant metastases and overal survival (OS) for patients... |
SourceID | wanfang chongqing |
SourceType | Aggregation Database Publisher |
StartPage | 309 |
SubjectTerms | 低位 切除术 多变量分析 手术治疗 晚期 直肠癌 肿瘤学 预后 |
Title | Five-year oncologic outcomes and prognostic factors for locally advanced low rectal cancer after low anterior resection |
URI | http://lib.cqvip.com/qk/90333A/201407/661774495.html https://d.wanfangdata.com.cn/periodical/dgyx201407003 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3Nb9MwFLfKkBAXxKcYg8kHfKoypbYTx8dkSzUh4NSJcaoSJymTpmRsrUr5E_irec92skwgBBwaVS9-aeX3y_tI3gchb7k2ETdFGXDFq0AKrgMIm1UQmaTSheRhZGy2xcf49Ey-O4_OJ5Mfo6ylzbo8Mt9_W1fyP1IFGsgVq2T_QbLDRYEA30G-cAQJw_GvZDwHVRXssBVP1xqnxabdZg0_Vd_4DgAdJtJhU9Z-sA6mFVoDdrm7TQC47LZTVH3YLAQp1352ONLt1l8AFxYqmUGO3qFluWRZwtITlkcsy1mmPCWTlpKyJGV5whLOsjnLFdOw2J4CljRmecz0CZ7FxXOmgX3OsmOmHVfGspldE7NEIXuiWTJk32bd9HOBn-pi-qloV2Arpu834wcZrnTUa90YU0S0mypzVPc0EeBLyREI1UjTilCPjLZwNaG_2IOwr48WAvPvZAAheV9vebfNNvgp4AlDuHiP3OdKRziH4YynQ_COczYxeO__av-G3JVh3r089un40rWrr-B92GKwtoE9GPkti8fkkQ84aOrQ84RM6vYpefDBp1Q8I9sBRHQAEe1BRAFE9BZE1IOIAoioBxHtQQSELXUgog5E1ILI0nsQ0QFEz8lini-OTwM_jSMwkRIB3OqqjiG-LUNTVbDftZFcNcZEljhrtEp0FBazogavshFVLQsDvqYx5Wymi0q8IHtt19YvCS1BI3BRm6jB5khKFjIxhkvRlGB9RaX2ycGwfcsr13RlOchnnxz6DV36W_FmWa123xBSYL9C8eqP7AfkIa50T9Fek7319aZ-A37lujy0Av8J5s1rwg |
link.rule.ids | 315,786,790,4043,27954,27955,27956 |
linkProvider | Springer Nature |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Five-year+oncologic+outcomes+and+prognostic+factors+for+locally+advanced+low+rectal+cancer+after+low+anterior+resection&rft.jtitle=%E4%B8%AD%E5%BE%B7%E4%B8%B4%E5%BA%8A%E8%82%BF%E7%98%A4%E5%AD%A6%E6%9D%82%E5%BF%97%EF%BC%9A%E8%8B%B1%E6%96%87%E7%89%88&rft.au=Bo+Yao+Yadi+Wang+Na+Lu&rft.date=2014&rft.issn=1610-1979&rft.eissn=1613-9089&rft.issue=7&rft.spage=309&rft.epage=315&rft_id=info:doi/10.1007%2Fs10330-014-1331-2&rft.externalDocID=661774495 |
thumbnail_s | http://utb.summon.serialssolutions.com/2.0.0/image/custom?url=http%3A%2F%2Fimage.cqvip.com%2Fvip1000%2Fqk%2F90333A%2F90333A.jpg http://utb.summon.serialssolutions.com/2.0.0/image/custom?url=http%3A%2F%2Fwww.wanfangdata.com.cn%2Fimages%2FPeriodicalImages%2Fdgyx%2Fdgyx.jpg |