Abstract：Objective To investigate the prognostic effects of pathological stages in patients with locally advanced rectal cancer after neoadjuvant radiochemotherapy (Neo-RCT) plus radical surgery. Methods A retrospective analysis was performed on the clinical data of 210 patients with locally advanced rectal cancer who were admitted to our hospital from 2003 to 2010 and were treated with Neo-RCT followed by radical surgery. After Neo-RCT plus radical surgery, the pathological stages included ypT0-2N (－)(91 patients, 43.3%), ypT3－4N (－)(69 patients, 32.9%), and ypT0-4N (+)(50 patients, 23.8%). The Kaplan-Meier method was used for calculating survival rates;the log-rank test was used for survival difference analysis and univariate analysis of prognostic factors for disease free survival (DFS);the Cox proportional hazard model was used for multivariate analysis of prognostic factors for DFS. Results The follow-up rate was 99%, and 64 patients were followed up for at least 5 years. After Neo-RCT plus radical surgery, the patients with ypT0-2 N (－), ypT3－4N (－), and ypT0-4N (+) rectal cancers had 5-year overall survival rates of 88%, 75%, and 65%, respectively (P=0.018), 5-year DFS rates of 81%, 78%, and 60%, respectively (P=0.005), and 5-year distant metastasis-free survival rates of 91%, 81%, and 64%(P=0.000). The multivariate analysis showed that ypN stage was the independent prognostic factor for DFS. Conclusions Pathological stage is strongly associated with the treatment outcome in patients with locally advanced rectal cancer treated with Neo-RCT followed by radical surgery, which may be used as guidance for postoperative individualized adjuvant therapy.
PENG Hai-hua,YOU Kai-yun,WANG Cheng-tao et al. Prognostic effects of pathological stages in patients with locally advanced rectal cancer after neoadjuvant radiochemotherapy plus radical surgery[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 439-442.
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