Is adjuvant radiotherapy warranted in resected pT1-2 node-positive rectal cancer?

Peng, J and Li, X and Ding, Y and Shi, D and Wu, H and Cai, S (2013) Is adjuvant radiotherapy warranted in resected pT1-2 node-positive rectal cancer? Radiation Oncology, 8 (1).

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Abstract

Background: Stage T1-2 rectal cancers are unlikely to have lymph node metastases and neoadjuvant therapy is not routinely administered. Postoperative management is controversial if lymph node metastases are detected in the resected specimen. We studied the outcomes of patients with pT1-2 node-positive rectal cancer in order to determine whether adjuvant radiotherapy was beneficial. Methods: We conducted a retrospective analysis of 284 patients with pathological T1-2 node-positive rectal cancer from a single institution. Outcomes, including local recurrence (LR), distant metastasis (DM), disease free survival (DFS) and overall survival (OS), were studied in patients with detailed TN staging and different adjuvant treatment modalities. Results: The overall 5-year LR, DM, DFS and OS rates for all patients were 12.5%, 32.9%, 36.4% and 76.8%, respectively. Local control was inferior among patients who received no adjuvant therapy. Patients could be divided into three risk subsets: Low-risk, T1N1; Intermediate-risk, T2N1 and T1N2; and High-risk, T2N2. The 5-year LR rates were 5.3%, 9.8% and 26.4%, respectively (p = 0.005). In High-risk patients, addition of radiotherapy achieved a 5-year LR rate of 9.1%, compared 34.8% without radiotherapy. Conclusions: In our study, we provide the detailed outcomes and preliminary survival analysis in a relatively infrequent subset of rectal cancer. Three risk subsets could be identified based on local control for pT1-2 node positive rectal cancer. Postoperative treatment needs to be individualized for patients with pT1-2 node-positive rectal cancer. © 2013 Peng et al.; licensee BioMed Central Ltd.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Peng, J Li, X Ding, Y YINGDING@pitt.edu YINGDING Shi, D Wu, H Cai, S
Date:	19 December 2013
Date Type:	Publication
Journal or Publication Title:	Radiation Oncology
Volume:	8
Number:	1
DOI or Unique Handle:	10.1186/1748-717x-8-290
Schools and Programs:	School of Public Health > Biostatistics
Refereed:	Yes
Date Deposited:	02 Dec 2016 18:31
Last Modified:	02 Feb 2019 13:55
URI:	http://d-scholarship.pitt.edu/id/eprint/29632

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