Predictive factors of positive circumferential resection margin after radiochemotherapy for rectal cancer: The French randomised trial ACCORD12/0405 PRODIGE 2

Autor: Jocelyne Bérille, Frédéric Bibeau, Isabelle Kleinclaus, Yves-Marie Robin, Isabelle Soubeyran, Catherine Chassagne-Clément, Bernard Denis, Anne Rullier, Marie-Agnès Diebold, Anne-Isabelle Lemaistre, Jean-François Mosnier, Agnès Leroux, Christophe Petitjean, Sophie Gourgou-Bourgade, Jean-Pierre Gerard, Michel Peoc'h, Marta Jarlier, Thierry Conroy, Christophe Hennequin, Laurent Tisseau, Laurent Mineur, Francette Ettore, Norbert Padilla
Přispěvatelé: CHU Bordeaux [Bordeaux], Centre Régional de Lutte contre le Cancer Val d'Aurelle, Centre Léon Bérard [Lyon], Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Laboratoire de Pathologie [Saint Brieuc], Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), CRLCC Antoine Lacassagne, Laboratoire de Pathologie [Saint Priest en Jarez], Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), CRLCC Oscar Lambret, Hôpital Louis Pasteur [Colmar] (CH Colmar), Institut Sainte Catherine [Avignon], Laboratoire medipath [Hyères], Hôpital Hôtel-Dieu [Nantes] (Centre Hospitalier Universitaire de Nantes), Institut Bergonié - CRLCC Bordeaux, Laboratoire de Pathologie [Le Mans], Laboratoire de Pathologie [Lyon], UNICANCER [Paris], Centre Antoine Lacassagne, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Institut Bergonié [Bordeaux], Université de Lille-UNICANCER
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
Cancer Research
medicine.medical_specialty
animal structures
Colorectal cancer
medicine.medical_treatment
MESH: Neoadjuvant Therapy
Gastroenterology
MESH: Prognosis
Capecitabine
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Digestive System Surgical Procedures
Neoadjuvant therapy
Neoplasm Staging
MESH: Chemoradiotherapy
MESH: Digestive System Surgical Procedures
MESH: Humans
MESH: Middle Aged
Rectal Neoplasms
Abdominoperineal resection
business.industry
Cancer
MESH: Rectal Neoplasms
Chemoradiotherapy
MESH: Neoplasm Staging
Middle Aged
Prognosis
medicine.disease
Neoadjuvant Therapy
MESH: Male
3. Good health
Surgery
Oxaliplatin
Clinical trial
MESH: France
Oncology
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
France
business
MESH: Female
medicine.drug
Zdroj: European Journal of Cancer
European Journal of Cancer, Elsevier, 2013, 49 (1), pp.82-89. ⟨10.1016/j.ejca.2012.06.028⟩
European Journal of Cancer, 2013, 49 (1), pp.82-89. ⟨10.1016/j.ejca.2012.06.028⟩
ISSN: 0959-8049
DOI: 10.1016/j.ejca.2012.06.028⟩
Popis: International audience; Circumferential resection margin (CRM) appears as a new powerful prognostic factor of survival after surgery for rectal cancer. We aimed to evaluate predictive factors of positive CRM following preoperative radiochemotherapy in a French trial. Patients with rectal cancer were randomised in long course preoperative radiotherapy 45 Gy plus capecitabine versus 50 Gy plus capecitabine and oxaliplatin. Mesorectal excision was performed 6 weeks after treatment. Impact of clinical, pathological and surgical variables on positive CRM (≤1 mm) were analysed by multivariate analysis. Of 565 randomised patients, CRM was recorded in 390 cases and was positive in 8% (30/390). Patients with 50 Gy plus capecitabine and oxaliplatin had a 6% rate of positive CRM while those treated by 45 Gy plus capecitabine had a 10% rate (p=0.128). Three independent predictive factors of positive CRM were identified: abdominoperineal resection (APR) (odds ratio OR=3.24; p=0.004), vascular tumour invasion (OR=2.78; p=0.026) and poor histological response (modified Dworak 0-2) (OR=9.01; p=0.003). Significant predictive factors of positive CRM are related to type of surgery, especially APR, and poor histological prognostic factors. Intensification of neoadjuvant radiochemotherapy does not seem to have a major role in this study.
Databáze: OpenAIRE
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