Survival-Effective Prognostic Factors of Rectal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy

Yıl 2024, Cilt: 1 Sayı: 2, 117 - 123, 14.06.2024

Orhan Uzun , Erdal Polat , Mustafa Duman , Selçuk Gülmez , Aziz Serkan Senger , Murşit Dinçer , Mehmet Ömer Özduman , Mehmet Torun

Öz

Aim: Our aim in this study is to investigate the survival-effective prognostic factors of rectal cancer patients receiving neoadjuvant chemoradiotherapy.
Material and Method: A total of 84 patients, including 54 patients with rectal cancer who received neoadjuvant CRT and 30 patients who did not receive it, were included in the study at the Gastroenterology Surgery Clinic of Health Sciences University Koşuyolu Yüksek Ihtisas Training and Research Hospital between January 2019 and October 2019. The data of the patients were retrospectively taken from the hospital automation system and used.
Results: 84 patients were included in our study. Of these patients, 40 were male(47%) and 44 were female(53%). The patients were followed for an average of 44 months. Neoadjuvant chemoradiotherapy treatment was applied to 64.3% of the 84 patients who underwent surgery for rectal cancer. According to Kaplein Meier long rank test analysis, no statistical difference was found in the survival Deciency between the two groups (p=0.115). The average life expectancy of patients receiving neoadjuvant chemoradiotherapy was 66.7±4.8 months, while in patients not receiving neoadjuvant therapy, it was found to be 76.6±4.4 months.
Conclusion: The incidence of rectal cancer is still high today. Neoadjuvant CRT at the local advanced stage is a standard treatment approach. In our study, the most important prognostic factor effective survival after neoadjuvant CRT was found to be the presence of lymph node metastasis after surgery.

Anahtar Kelimeler

Rectum Cancer, Neoadjuvant Cemoradioterapy, Lymph Node

Kaynakça

• Ogura A, Konishi T, Cunningham C, et al. Neoadjuvant (Chemo radiotherapy With Total Mesorectal Excision Only Is Not Sufficient to Prevent Lateral Local Recurrence in Enlarged Nodes: Results of the Multicenter Lateral Node Study of Patients With Low cT3/4 Rectal Cancer. J Clin Oncol. 2019;37(1):33-43. doi:10.1200/JCO.18.00032
• Zorcolo L, Rosman AS, Restivo A, et al. Complete pathologic response after combined modality treatment for rectal cancer and long-term survival: a meta-analysis. Ann Surg Oncol. 2012;19(9):2822-2832. doi:10.1245/s10434-011-2209-y
• Paschke S, Jafarov S, Staib L, et al. Are Colon and Rectal Cancer Two Different Tumor Entities? A Proposal to Abandon the Term Colorectal Cancer. Int J Mol Sci. 2018;19(9):2577. Published 2018 Aug 30. doi:10.3390/ijms19092577
• Paun BC, Cassie S, MacLean AR, Dixon E, Buie WD. Postoperative complications following surgery for rectal cancer. Ann Surg. 2010;251(5):807-818. doi:10.1097/SLA.0b013e3181dae4ed
• Couwenberg AM, Burbach JPM, van Grevenstein WMU, et al. Effect of Neoadjuvant Therapy and Rectal Surgery on Healthrelated Quality of Life in Patients With Rectal Cancer During the First 2 Years After Diagnosis. Clin Colorectal Cancer. 2018;17(3):e499-e512. doi:10.1016/j.clcc.2018.03.009
• Fan S, Li T, Zhou P, Peng Q, Zhu Y. Development and validation of nomogram combining serum biomarker for predicting survival in patients with resected rectal cancer. Biosci Rep. 2019;39(11):BSR20192636. doi:10.1042/BSR20192636
• Fleshman J, Branda ME, Sargent DJ, Boller AM, George VV, Abbas MA, et al. Disease-free Survival and Local Recurrence for Laparoscopic Resection Compared With Open Resection of Stage II to III Rectal Cancer: Follow-up Results of the ACOSOG Z6051 Randomized Controlled Trial. Ann Surg. 2019;269:589–95. doi:10.1097/SLA.0000000000003002.
• Mirzaee M, Azmandian J, Zeraati H, et al. Short-term and longterm survival of kidney allograft: cure model analysis. Iran J Kidney Dis. 2014;8(3):225-230.
• Merchea A, Ali SM, Kelley SR, Duchalais E, Alabbad JY, Dozois EJ, et al. Long-Term Oncologic Outcomes of Minimally Invasive Proctectomy for Rectal Adenocarcinoma. J Gastrointest Surg. 2018;22:1412–7. doi:10.1007/s11605-018-3751-8.
• Saito N, Sugito M, Ito M, et al. Oncologic outcome of intersphincteric resection for very low rectal cancer. World J Surg. 2009;33(8):1750-1756. doi:10.1007/s00268-009-0079-2.
• Chang GJ, Rodriguez-Bigas MA, Eng C, Skibber JM. Lymph node status after neoadjuvant radiotherapy for rectal cancer is a biologic predictor of outcome. Cancer. 2009;115(23):5432-5440. doi:10.1002/cncr.24622
• Lindebjerg J, Spindler KL, Ploen J, Jakobsen A. The prognostic value of lymph node metastases and tumour regression grade in rectal cancer patients treated with long-course preoperative chemoradiotherapy. Colorectal Dis. 2009;11(3):264-269. doi:10.1111/j.1463-1318.2008.01599.x
• Rödel C, Martus P, Papadoupolos T, et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J Clin Oncol. 2005;23(34):8688-8696. doi:10.1200/JCO.2005.02.1329
• Minsky BD. Adjuvant therapy for rectal cancer--the transatlantic view. Colorectal Dis. 2003;5(5):416-422. doi:10.1046/j.1463-1318.2003.00504.x