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Adjuvant radiotherapy following total mesorectal excision for stage IIA rectal cancer: is it beneficial?

Authors
 Jin Soo Kim  ;  Nam Kyu Kim  ;  Byung Soh Min  ;  Hyuk Hur  ;  Joong Bae Ahn  ;  Ki Chang Keum 
Citation
 INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol.25(9) : 1103-1110, 2010 
Journal Title
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
ISSN
 0179-1958 
Issue Date
2010
MeSH
Aged ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/radiotherapy ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Postoperative Care ; Postoperative Complications/etiology ; Radiotherapy, Adjuvant/adverse effects ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/radiotherapy* ; Rectal Neoplasms/surgery* ; Survival Analysis
Keywords
Rectal neoplasm ; Radiotherapy ; Adjuvant therapy ; Total mesorectal excision
Abstract
PURPOSE: The benefit of adjuvant radiotherapy in patients with stage IIA (T3N0) rectal cancer following total mesorectal excision (TME) is controversial. We evaluated the effect of adjuvant chemoradiotherapy (CRT) versus chemotherapy (CT) alone on the local recurrence and survival of patients with stage IIA rectal cancer after TME. METHODS: Between 1996 and 2004, patients with stage IIA rectal cancer who received adjuvant CT (n = 29) or CRT (n = 122) following TME were enrolled. Oncologic outcomes were compared between groups, and risk factors for local recurrence and overall survival rates were analyzed. RESULTS: The median follow-up period was 78 months. No significant differences were observed in the 5-year local recurrence (3.4% versus 9.0%; P = 0.348) or 5-year overall survival rates (86.2% versus 80.3%; P = 0.924) between CT and CRT. However, involvement of the circumferential resection margin and age >60 years were associated with adverse oncologic outcomes. CONCLUSIONS: Additional postoperative radiotherapy did not alter local recurrence or survival after TME in patients with stage IIA rectal cancer. Postoperative radiation may be an overtreatment as an adjuvant therapy in patients with stage IIA rectal cancer if they had no other risk factors. However, randomized controlled trials are warranted to confirm this suggestion.
Full Text
http://link.springer.com/article/10.1007%2Fs00384-010-0970-1
DOI
10.1007/s00384-010-0970-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101671
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