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Pathologic Complete Response of Primary Tumor Following Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer Long-term Outcomes and Prognostic Significance of Pathologic Nodal Status (KROG 09-01)

Cited 117 time in Web of Science Cited 130 time in Scopus
Authors
Yeo, Seung-Gu; Kim, Dae Yong; Kim, Tae Hyun; Chang, Hee Jin; Park, Won; Nam, Heerim; Cho, Moon-June; Park, Jin-hong; Koom, Woong Sub; Lee, Kyung-Ja; Kim, Jung Soo; Chie, Eui Kyu; Nam, Taek-Keun; Kim, Jae-Sung; Kang, Min Kyu; Kim, Jong Hoon; Kim, Jun-Sang; Choi, Doo Ho; Oh, Jae Hwan
Issue Date
2010-12
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
ANNALS OF SURGERY; Vol.252 6; 998-1004
Abstract
Objective: To investigate long-term outcomes of locally advanced rectal cancer (LARC) patients with postchemoradiotherapy (post-CRT) pathologic complete response of primary tumor (ypT0) and determine prognostic significance of post-CRT pathologic nodal (ypN) status. Background: LARC patients with post-CRT pathologic complete response were suggested to have favorable long-term outcomes, but prognostic significance of ypN status has never been specifically defined in ypT0 patients. Methods: The Korean Radiation Oncology Group collected clinical data for 333 LARC patients with ypT0 following preoperative CRT and curative radical resections between 1993 and 2007. Sphincter preservation surgery and abdominoperineal resection were performed in 283 (85.0%) and 50 (15.0%) patients, respectively. Postoperative chemotherapy was given to 285 (85.6%) patients. Survival was estimated by the Kaplan-Meier method, and the Cox proportional hazard model was used in multivariate analyses. Results: After median follow-up of 43 (range = 14-172) months, 5-year disease-free survival (DFS) was 84.6% and overall survival (OS) was 92.8%. The ypN status was ypT0N0 in 304 (91.3%), ypT0N1 in 22 (6.6%), and ypT0N2 in 7 (2.1%) patients. The ypN status was the most relevant independent prognostic factor for both DFS and OS in ypT0 patients. The 5-year DFS and OS was 88.5% and 94.8% in ypT0N0 patients, and 45.2% and 72.8% in ypT0N+ patients (both, P < 0.001). Conclusions: LARC patients achieving ypT0N0 after preoperative CRT had favorable long-term outcomes, whereas positive ypN status had a poor prognosis even after total regression of primary tumor.
ISSN
0003-4932
Language
English
URI
http://hdl.handle.net/10371/77101
DOI
https://doi.org/10.1097/SLA.0b013e3181f3f1b1
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College of Medicine/School of Medicine (의과대학/대학원)Radiation Oncology (방사선종양학전공)Journal Papers (저널논문_방사선종양학전공)
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