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Pathologic complete response of primary tumor following preoperative chemoradiotherapy for locally advanced rectal cancer: long-term outcomes and prognostic significance of pathologic nodal status (KROG 09-01).

Authors
 Seung-Gu Yeo  ;  Dae Yong Kim  ;  Tae Hyun Kim  ;  Hee Jin Chang  ;  Jae Hwan Oh  ;  Won Park  ;  Doo Ho Choi  ;  Heerim Nam  ;  Jun-Sang Kim  ;  Moon-June Cho  ;  Jong Hoon Kim  ;  Jin-hong Park  ;  Min Kyu Kang  ;  Woong Sub Koom  ;  Jae-Sung Kim  ;  Taek-Keun Nam  ;  Eui Kyu Chie  ;  Jung Soo Kim  ;  Kyung-Ja Lee 
Citation
 ANNALS OF SURGERY, Vol.252(6) : 998-1004, 2010 
Journal Title
ANNALS OF SURGERY
ISSN
 0003-4932 
Issue Date
2010
MeSH
Antineoplastic Agents/therapeutic use* ; Chemotherapy, Adjuvant ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Preoperative Care ; Prognosis ; Radiotherapy, Adjuvant* ; Rectal Neoplasms/pathology* ; Rectal Neoplasms/surgery ; Rectal Neoplasms/therapy ; Remission Induction ; Treatment Outcome
Abstract
OBJECTIVE: To investigate long-term outcomes of locally advanced rectal cancer (LARC) patients with postchemoradiotherapy (post-CRT) pathologic complete response of primary tumor (ypT0) and determine prognostic significance of post-CRT pathologic nodal (ypN) status. BACKGROUND: LARC patients with post-CRT pathologic complete response were suggested to have favorable long-term outcomes, but prognostic significance of ypN status has never been specifically defined in ypT0 patients. METHODS: The Korean Radiation Oncology Group collected clinical data for 333 LARC patients with ypT0 following preoperative CRT and curative radical resections between 1993 and 2007. Sphincter preservation surgery and abdominoperineal resection were performed in 283 (85.0%) and 50 (15.0%) patients, respectively. Postoperative chemotherapy was given to 285 (85.6%) patients. Survival was estimated by the Kaplan-Meier method, and the Cox proportional hazard model was used in multivariate analyses. RESULTS: After median follow-up of 43 (range = 14-172) months, 5-year disease-free survival (DFS) was 84.6% and overall survival (OS) was 92.8%. The ypN status was ypT0N0 in 304 (91.3%), ypT0N1 in 22 (6.6%), and ypT0N2 in 7 (2.1%) patients. The ypN status was the most relevant independent prognostic factor for both DFS and OS in ypT0 patients. The 5-year DFS and OS was 88.5% and 94.8% in ypT0N0 patients, and 45.2% and 72.8% in ypT0N+ patients (both, P < 0.001). CONCLUSIONS: LARC patients achieving ypT0N0 after preoperative CRT had favorable long-term outcomes, whereas positive ypN status had a poor prognosis even after total regression of primary tumor.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000658-201012000-00015&LSLINK=80&D=ovft
DOI
10.1097/SLA.0b013e3181f3f1b1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/102874
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