Prognostic Impact of Circumferential Resection Margin in Rectal Cancer Treated with Preoperative Chemoradiotherapy

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• 作者：Mi Ri Hwang MD (1)
  Ji Won Park MD (1) (4) (5) (6)
  Sohee Park PhD (2)
  Hyekyoung Yoon MS (3)
  Dae Yong Kim MD (1)
  Hee Jin Chang MD (1)
  Sun Young Kim MD (1)
  Sung Chan Park MD (1)
  Hyo Seong Choi MD (1)
  Jae Hwan Oh MD (1)
  Seung-Yong Jeong MD (4) (5) (6)
  
• 刊名：Annals of Surgical Oncology
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：21
• 期：4
• 页码：1345-1351
• 全文大小：258 KB
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• 作者单位：Mi Ri Hwang MD (1)
  Ji Won Park MD (1) (4) (5) (6)
  Sohee Park PhD (2)
  Hyekyoung Yoon MS (3)
  Dae Yong Kim MD (1)
  Hee Jin Chang MD (1)
  Sun Young Kim MD (1)
  Sung Chan Park MD (1)
  Hyo Seong Choi MD (1)
  Jae Hwan Oh MD (1)
  Seung-Yong Jeong MD (4) (5) (6)
  
  1. Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi-do, Korea
  4. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
  5. Cancer Research Institute, Seoul National University, Seoul, Korea
  6. Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul, Korea
  2. Department of Epidemiology and Heath Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
  3. Cancer Biostatistics Branch, Research Institute, National Cancer Center, Goyang, Korea
  
• ISSN：1534-4681

文摘

Background The circumferential resection margin (CRM) is a strong prognostic factor in rectal cancer. The purpose of this study was to investigate the relationship between CRM distance and recurrence in patients with locally advanced rectal cancer who received preoperative chemoradiotherapy (CRT). Methods We analyzed data for 561 patients who underwent preoperative CRT and curative surgery for locally advanced rectal cancer between August 2001 and December 2008. CRM was divided into four groups: group 1, CRM?>?2?mm; group 2, 1.1-.0?mm; group 3, 0.1-.0?mm; and group 4, 0?mm. We assessed the associations of CRM with local recurrence and disease-free survival. Results Groups 1, 2, 3, and 4 comprised 487, 36, 20, and 18 patients, respectively. The local recurrence rate was highest and the disease-free survival rate was lowest in group 4, followed by groups 3, 2, and 1. Survival was similar between groups 2 and 1. Local recurrence rates were lower in groups 3, 2, and 1 than in group 4 [hazard ratio (HR) 0.28, 95?% confidence interval (CI) 0.09-.91, P?=?0.035; HR 0.11, 95?% CI 0.03-.46, P?=?0.002; HR 0.18, 95?% CI 0.08-.42, P?<?0.0001, respectively]. Disease-free survival rates were higher in groups 3, 2, and 1 than in group 4 (HR 0.32, 95?% CI 0.13-.75, P?=?0.009; HR 0.24, 95?% CI 0.10-.54, P?=?0.001; HR 0.26, 95?% CI 0.14-.48, P?<?0.0001, respectively). Conclusions After preoperative CRT, CRM distance provides useful information for risk stratification in the recurrence of rectal cancer.