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Early recurrence after neoadjuvant chemoradiation therapy for locally advanced rectal cancer: Characteristics and risk factors

Authors
 Han-Gil Kim  ;  Ho Seung Kim  ;  Seung Yoon Yang  ;  Yoon Dae Han  ;  Min Soo Cho  ;  Hyuk Hur  ;  Byung Soh Min  ;  Kang Young Lee  ;  Nam Kyu Kim 
Citation
 ASIAN JOURNAL OF SURGERY, Vol.44(1) : 298-302, 2021-01 
Journal Title
ASIAN JOURNAL OF SURGERY
ISSN
 1015-9584 
Issue Date
2021-01
Keywords
Neoadjuvant chemoradiation ; Rectal cancer ; Recurrence
Abstract
Background/objective: Some locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (CRT) prior to total mesorectal excision (TME) show early recurrence with a short disease-free interval. This is unacceptable for patients and their families, necessitating re-evaluation of the treatment process. We aimed to evaluate the risk factors and prognostic impact of early recurrence in patients who received preoperative CRT (pCRT) followed by TME for LARC.

Methods: Of 714 patients who underwent curative resection after pCRT for LARC from January 2010 to December 2016, we included 139 who developed recurrence after resection. Patients were divided into an early recurrence group, diagnosed <12 months after primary surgery, and a late recurrence group, diagnosed ≥12 months after primary surgery.

Results: Forty-nine patients experienced early recurrence and 90 experienced late recurrence. Multivariate analysis revealed that tumor regression grade (hazard ratio [HR] 2.962, 95% confidence interval [CI] 1.434-6.119, P = 0.003) and positive ypN stage (HR 2.110, 95% CI 1.144-3.892, P = 0.017) correlated with early recurrence. The 5-year overall survival rates for early and late recurrences were not significantly different (P = 0.121).

Conclusion: In patients with early recurrence after pCRT followed by TME, tumor regression grade and ypN stage positivity were independent predictors of the early recurrence.
Files in This Item:
T202100139.pdf Download
DOI
10.1016/j.asjsur.2020.07.014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
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
Yang, Seung Yoon(양승윤) ORCID logo https://orcid.org/0000-0001-8129-7712
Lee, Kang Young(이강영)
Cho, Min Soo(조민수)
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181979
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