Long-term Outcomes of Lower Rectal Cancer Patients Treated with Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection after Preoperative Radiotherapy or Chemoradiotherapy
| Autor: | Wataru Sakamoto, Koji Kono, Shinji Ohki, Hirokazu Okayama, Motonobu Saito, Hisahito Endo, Shotaro Fujita, Zenichiro Saze, Seiichi Takenoshita, Tomoyuki Momma, Hisashi Onozawa |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Chemotherapy genetic structures business.industry Colorectal cancer medicine.medical_treatment Therapeutic effect lateral pelvic lymph node dissection RC799-869 Diseases of the digestive system. Gastroenterology medicine.disease Total mesorectal excision chemoradiotherapy Radiation therapy Dissection medicine.anatomical_structure Medicine Radiology Original Research Article business rectal cancer Lymph node Chemoradiotherapy radiotherapy lateral pelvic node metastasis |
| Zdroj: | Journal of the Anus, Rectum and Colon Journal of the Anus, Rectum and Colon, Vol 5, Iss 2, Pp 129-136 (2021) |
| ISSN: | 2432-3853 |
| Popis: | Objectives The standard strategy for advanced rectal cancer (RC) is preoperative short-course radiotherapy (SCRT)/chemoradiotherapy (CRT) plus total mesorectal excision (TME) in Western countries; however, the survival benefit of adding chemotherapy to radiotherapy remains unclear. There is accumulating evidence that either SCRT/CRT or lateral pelvic lymph node dissection (LPND) alone may not be sufficient for local control of advanced RC. We herein retrospectively evaluated the clinical outcomes of patients who were treated by SCRT/CRT+TME+LPND, particularly focusing on the prognostic impact of lateral pelvic lymph node metastasis (LPNM). Methods Patients diagnosed as having clinical Stage II and III lower RC who received SCRT/CRT+TME+LPND between 1999 and 2012 at our hospital were enrolled. Adverse events (AEs), surgery-related complications (SRC), and therapeutic effects were retrospectively analyzed. Results Fifty cases (SCRT:25, CRT:25) were analyzed. No significant differences were observed in overall survival (OS), relapse-free survival (RFS), local recurrence (LR), AE, and SRC between the SCRT and CRT groups, although the pathological therapeutic effect was higher in the CRT group. The patients with LPNM showed significantly inferior 5-year OS and 5-year RFS than those without LPNM. Conclusions There were no significant differences in OS, RFS, or LR between SCRT and CRT, although CRT had a significantly greater histological therapeutic effect. The prognosis of the pathological LPNM-positive cases was significantly poorer than that of pathological LPNM-negative cases. |
| Databáze: | OpenAIRE |
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