دورية أكاديمية
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Neoadjuvant Chemoradiation for Rectal Cancer Achieves Satisfactory Tumour Regression and Local Recurrence - Result of a Dedicated Multi-disciplinary Approach from a South Asian Centre.

التفاصيل البيبلوغرافية
العنوان: Neoadjuvant Chemoradiation for Rectal Cancer Achieves Satisfactory Tumour Regression and Local Recurrence - Result of a Dedicated Multi-disciplinary Approach from a South Asian Centre.
المؤلفون: Deen R; Department of Surgery, Wollongong Hospital, Wollongong, NSW, Australia. raeeddeen30@gmail.com., Ediriweera DS; Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka., Thillakaratne S; Department of Surgery, University of Kelaniya, Kelaniya, Sri Lanka., Hewavissenthi J; Department of Pathology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka., Kumarage SK; Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka., Chandrasinghe PC; Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.; The Department of Surgery, University of Kelaniya and North Colombo Teaching Hospital, Ragama, Sri Lanka.
المصدر: BMC cancer [BMC Cancer] 2023 May 04; Vol. 23 (1), pp. 400. Date of Electronic Publication: 2023 May 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Rectal Neoplasms*/radiotherapy , Rectal Neoplasms*/drug therapy , Proctectomy*, Humans ; Male ; Female ; Middle Aged ; Neoadjuvant Therapy ; Chemoradiotherapy ; Lymph Nodes/pathology ; Neoplasm Staging ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/prevention & control ; Neoplasm Recurrence, Local/pathology ; Treatment Outcome
مستخلص: Background: Pre-operative long-course chemoradiotherapy (CRT) for rectal cancer has resulted in improvement in rates of restorative rectal resection and local recurrence by inducing tumour downstaging and downsizing. Total mesorectal excision (TME) is a standardised surgical technique of low anterior resection aimed at the prevention of local tumour recurrence. The purpose of this study was to evaluate tumour response following CRT in a standardised group of patients with rectal cancer.
Methods: One hundred and thirty-one patients (79 male; 52 female, median age 57; interquartile range 47-62 years) of 153 with rectal cancer who underwent pre-operative long-course CRT were treated by standardised open low anterior resection at a median of 10 weeks post-CRT. Sixteen of 131 (12%) were 70 years or older. Median follow-up at the time of analysis was 15 months (interquartile range 6-45 months). Pathology reports were analysed based on AJCC-UICC classification using the TNM system. Data recorded were overall/subgrades of tumour regression; good, moderate or poor, lymph node harvest, local recurrence, disease-free and overall survival using standard statistical methods.
Results: 78% showed tumour regression post-CRT; 43% displayed good tumour regression/response while 22% had poor tumour regression/response. All patients had a pre-operative T-stage of either T3 or T4. Post-operation, good responders had a median T stage of T2 vs. T3 in poor responders (P = 0.0002). Overall, the median lymph node harvest was < 12. There was no difference in the number of nodes harvested in good vs. poor responders (Good/moderate-6 nodes vs. Poor- 8; P = 0.31). Good responders tended to have a lesser number of malignant nodes vs. poor responders (P = 0.31). Overall, local recurrence was 6.8% and the anal sphincter preservation rate was 89%. Predicted 5-year disease-free and overall survival were similar between good and poor responders.
Conclusion: Long-course CRT resulted in satisfactory tumour regression and enabled consideration for safe, sphincter-saving resection in rectal cancer. A dedicated multi-disciplinary team approach achieved a global benchmark for local recurrence in a resource-limited setting.
(© 2023. The Author(s).)
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معلومات مُعتمدة: #00-25 National Research Council Sri Lanka; #00-25 National Research Council Sri Lanka; #00-25 National Research Council Sri Lanka; #00-25 National Research Council Sri Lanka
فهرسة مساهمة: Keywords: Chemoradiation; Local recurrence; Lymph node harvest; Rectal cancer; Tumour regression
تواريخ الأحداث: Date Created: 20230504 Date Completed: 20230508 Latest Revision: 20230508
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10158249
DOI: 10.1186/s12885-023-10769-7
PMID: 37142979
قاعدة البيانات: MEDLINE
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