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Abdominoperineal excision following preoperative radiotherapy for rectal cancer: Unfavorable prognosis even with negative circumferential resection margin
Wang, Lin1; Gu, Guo-Li3; Li, Zhong-Wu2; Peng, Yi-Fan1; Gu, Jin1
关键词Abdominoperineal Excision Preoperative Radiotherapy Circumferential Resection Margin Survival
刊名WORLD JOURNAL OF GASTROENTEROLOGY
2014-07-21
DOI10.3748/wjg.v20.i27.9138
20期:27页:9138-9145
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Gastroenterology & Hepatology
研究领域[WOS]Gastroenterology & Hepatology
关键词[WOS]TOTAL MESORECTAL EXCISION ; DISEASE-FREE SURVIVAL ; PHASE-III TRIAL ; SPHINCTER PRESERVATION ; LOCAL RECURRENCE ; POSTOPERATIVE CHEMORADIOTHERAPY ; NEOADJUVANT RADIOTHERAPY ; ONCOLOGICAL OUTCOMES ; REGRESSION GRADE ; RANDOMIZED-TRIAL
英文摘要

AIM: To evaluate whether an abdominoperineal excision (APE) is associated with increased local recurrence (LR) and shortened disease-free survival (DFS) in mid-low rectal cancer with a negative circumferential resection margin (CRM).

METHODS: 283 consecutive cases of mid-low rectal cancer underwent preoperative 30 Gy/10 F radiotherapy and surgery in Peking University Cancer Hospital between August 2003 and August 2009. Patients with positive CRM and intraoperative distant metastasis were precluded according to exclusion criteria. Survival analyses were performed in patients with APE or non-APE procedures.

RESULTS: 256 of the 283 (90.5%) cases were enrolled in the analysis, including 78 (30.5%) and 178 (69.5%) cases who received APE and non-APE procedures. Fewer female patients (P = 0.016), lower level of tumor (P = 0.000) and higher body mass index (P = 0.006) were found in the APE group. On univariate analysis, the APE group had a higher LR rate (5.1% vs 1.1%, P = 0.036) and decreased DFS (73.1% vs 83.4%, P = 0.021). On multivariate analysis, APE procedure was also an independent risk factor for LR (HR = 5.960, 1.085-32.728, P = 0.040) and decreased DFS (HR = 2.304, 1.298-4.092, P = 0.004). In stratified analysis for lower rectal cancer, APE procedure was still an independent risk factor for higher LR rate (5.6% vs 0%, P = 0.024) and shortened DFS (91.5% vs 73.6%, P = 0.002).

CONCLUSION: Following preoperative 30 Gy/10 F radiotherapy, APE procedure was still a predictor for LR and decreased DFS even with negative CRM. More intensive preoperative treatment should be planned for the candidates who are scheduled to receive APE with optimal imaging assessment. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

语种英语
WOS记录号WOS:000339389600038
项目编号ZY201410
资助机构Beijing Municipal Administration of Hospitals Clinical Medicine Development
引用统计
被引频次:3[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/57342
专题北京大学临床肿瘤学院_胃肠肿瘤中心
北京大学临床肿瘤学院_病理科
作者单位1.Air Force Gen Hosp, Dept Gen Surg, Beijing 100142, Peoples R China
2.Peking Univ, Canc Hosp & Inst, Dept Colorectal Surg, Key Lab Carcinogenesis & Translat Res,Minist Educ, Beijing 100142, Peoples R China
3.Peking Univ, Canc Hosp & Inst, Dept Gastroenterol,Minist Educ, Dept Pathol,Key Lab Carcinogenesis & Translat Res, Beijing 100142, Peoples R China
推荐引用方式
GB/T 7714
Wang, Lin,Gu, Guo-Li,Li, Zhong-Wu,et al. Abdominoperineal excision following preoperative radiotherapy for rectal cancer: Unfavorable prognosis even with negative circumferential resection margin[J]. WORLD JOURNAL OF GASTROENTEROLOGY,2014,20(27):9138-9145.
APA Wang, Lin,Gu, Guo-Li,Li, Zhong-Wu,Peng, Yi-Fan,&Gu, Jin.(2014).Abdominoperineal excision following preoperative radiotherapy for rectal cancer: Unfavorable prognosis even with negative circumferential resection margin.WORLD JOURNAL OF GASTROENTEROLOGY,20(27),9138-9145.
MLA Wang, Lin,et al."Abdominoperineal excision following preoperative radiotherapy for rectal cancer: Unfavorable prognosis even with negative circumferential resection margin".WORLD JOURNAL OF GASTROENTEROLOGY 20.27(2014):9138-9145.
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