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Oncologic outcomes after radical surgery following preoperative chemoradiotherapy for locally advanced lower rectal cancer: abdominoperineal resection versus sphincter-preserving procedure

DC FieldValueLanguage
dc.contributor.author조선연-
dc.contributor.author조장환-
dc.contributor.author허혁-
dc.contributor.author금기창-
dc.contributor.author김남규-
dc.contributor.author김영완-
dc.contributor.author김정연-
dc.contributor.author김호근-
dc.contributor.author민병소-
dc.contributor.author손승국-
dc.contributor.author안중배-
dc.date.accessioned2015-04-24T17:00:58Z-
dc.date.available2015-04-24T17:00:58Z-
dc.date.issued2009-
dc.identifier.issn1068-9265-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/104599-
dc.description.abstractBACKGROUND: Over the past several years, preoperative chemoradiotherapy (CRT) has contributed remarkably to make more sphincter-preserving procedure (SPP) possible for lower rectal cancer. The aim of this study was to compare the outcomes between abdominoperineal resection (APR) and SPP after preoperative CRT in patients with locally advanced lower rectal cancer. METHODS: A retrospective investigation was conducted with a total of 122 patients who underwent radical surgery combined with preoperative CRT for locally advanced lower rectal cancer. Of these, 50 patients underwent APR and 72 received SPP. Surgery was performed 6-8 weeks after completion of preoperative CRT. Oncologic outcomes were compared between the two groups, and the clinicopathologic factors affecting the treatment outcomes were evaluated. RESULTS: Circumferential resection margin (CRM) involvement (P = 0.037) and postoperative complication rate (P = 0.032) were significantly different between APR and SPP. Patients who underwent APR had a higher 5-year local recurrence (22.0% vs. 11.5%, P = 0.028) and lower 5-year cancer-specific survival (52.9% vs. 71.1%, P = 0.03) rate than those who underwent SPP. Pathologic N stage was the most critical predictor for local recurrence and survival. CONCLUSIONS: Our study shows that APR following preoperative CRT exhibited more adverse oncologic outcomes compared with SPP. This result may be due to higher rates of CRM involvement in APR even with preoperative CRT. We suggest that sharp perineal dissection and wider cylindrical excision at the level of the anorectal junction are required to avoid CRM involvement and improve oncologic outcomes in patients who undergo APR following preoperative CRT.-
dc.description.statementOfResponsibilityopen-
dc.format.extent1266~1273-
dc.relation.isPartOfANNALS OF SURGICAL ONCOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHChemotherapy, Adjuvant-
dc.subject.MESHColectomy/methods*-
dc.subject.MESHCombined Modality Therapy-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoadjuvant Therapy-
dc.subject.MESHNeoplasm Staging-
dc.subject.MESHRadiotherapy, Adjuvant-
dc.subject.MESHRectal Neoplasms/pathology-
dc.subject.MESHRectal Neoplasms/surgery-
dc.subject.MESHRectal Neoplasms/therapy*-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHTreatment Outcome-
dc.titleOncologic outcomes after radical surgery following preoperative chemoradiotherapy for locally advanced lower rectal cancer: abdominoperineal resection versus sphincter-preserving procedure-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorJin Soo Kim-
dc.contributor.googleauthorHyuk Hur-
dc.contributor.googleauthorNam Kyu Kim-
dc.contributor.googleauthorYoung Wan Kim-
dc.contributor.googleauthorSun Yeon Cho-
dc.contributor.googleauthorJeong Yeon Kim-
dc.contributor.googleauthorByung Soh Min-
dc.contributor.googleauthorJoong Bae Ahn-
dc.contributor.googleauthorKi Chang Keum-
dc.contributor.googleauthorHoguen Kim-
dc.contributor.googleauthorSeung Kook Sohn-
dc.contributor.googleauthorChang Hwan Cho-
dc.identifier.doi10.1245/s10434-009-0338-3-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03828-
dc.contributor.localIdA03894-
dc.contributor.localIdA04373-
dc.contributor.localIdA00272-
dc.contributor.localIdA00353-
dc.contributor.localIdA00720-
dc.contributor.localIdA00889-
dc.contributor.localIdA01183-
dc.contributor.localIdA01402-
dc.contributor.localIdA01978-
dc.contributor.localIdA02262-
dc.relation.journalcodeJ00179-
dc.identifier.eissn1534-4681-
dc.identifier.pmid19224287-
dc.identifier.urlhttp://link.springer.com/article/10.1245%2Fs10434-009-0338-3-
dc.subject.keywordAnal Sphincter-
dc.subject.keywordAnterior Resection-
dc.subject.keywordTotal Mesorectal Excision-
dc.subject.keywordOncologic Outcome-
dc.subject.keywordCircumferential Resection Margin-
dc.contributor.alternativeNameCho, Sun Yeon-
dc.contributor.alternativeNameCho, Chang Hwan-
dc.contributor.alternativeNameHur, Hyuk-
dc.contributor.alternativeNameKeum, Ki Chang-
dc.contributor.alternativeNameKim, Nam Kyu-
dc.contributor.alternativeNameKim, Young Wan-
dc.contributor.alternativeNameKim, Jeong Yeon-
dc.contributor.alternativeNameKim, Ho Keun-
dc.contributor.alternativeNameMin, Byung Soh-
dc.contributor.alternativeNameSohn, Seung Kook-
dc.contributor.alternativeNameAhn, Joong Bae-
dc.contributor.affiliatedAuthorCho, Sun Yeon-
dc.contributor.affiliatedAuthorCho, Chang Hwan-
dc.contributor.affiliatedAuthorHur, Hyuk-
dc.contributor.affiliatedAuthorKeum, Ki Chang-
dc.contributor.affiliatedAuthorKim, Nam Kyu-
dc.contributor.affiliatedAuthorKim, Young Wan-
dc.contributor.affiliatedAuthorKim, Jeong Yeon-
dc.contributor.affiliatedAuthorKim, Ho Keun-
dc.contributor.affiliatedAuthorMin, Byung Soh-
dc.contributor.affiliatedAuthorSohn, Seung Kook-
dc.contributor.affiliatedAuthorAhn, Joong Bae-
dc.citation.volume16-
dc.citation.number5-
dc.citation.startPage1266-
dc.citation.endPage1273-
dc.identifier.bibliographicCitationANNALS OF SURGICAL ONCOLOGY, Vol.16(5) : 1266-1273, 2009-
dc.identifier.rimsid52802-
dc.type.rimsART-
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 Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

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