AI Article Synopsis
- Patients with locally advanced rectal cancer (LARC) generally have poor outcomes, prompting a study on recurrence risks in those treated with chemoradiotherapy and surgery.
- The study involved 335 patients, with an emphasis on analyzing factors linked to locoregional recurrence (LRR) over an extensive median follow-up period of 72.6 months.
- Key findings identified several high-risk factors for LRR, including distal margin distance, resection status, and tumor grade, leading to the development of a prognostic index to improve personalized treatment strategies.
Article Abstract
Background: Patients with locally advanced rectal cancer (LARC) have a dismal prognosis. We investigated outcomes and risk factors for locoregional recurrence (LRR) in patients treated with preoperative chemoradiotherapy (CRT), surgery and IOERT.
Methods: A total of 335 patients with LARC [⩾cT3 93% and/or cN+ 69%) were studied. In multivariate analyses, risk factors for LRR, IFLR and OFLR were assessed.
Results: Median follow-up was 72.6 months (range, 4-205). In multivariate analysis distal margin distance ⩽10 mm [HR 2.46, p = 0.03], R1 resection [HR 5.06, p = 0.02], tumor regression grade 1-2 [HR 2.63, p = 0.05] and tumor grade 3 [HR 7.79, p < 0.001] were associated with an increased risk of LRR. A risk model was generated to determine a prognostic index for individual patients with LARC.
Conclusions: Overall results after multimodality treatment of LARC are promising. Classification of risk factors for LRR has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.
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| http://dx.doi.org/10.1016/j.radonc.2014.05.012 | DOI Listing |
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