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International Journal of Colorectal Disease

, Volume 32, Issue 3, pp 349–356 | Cite as

Does the depth of mesorectal invasion have prognostic significance in patients with ypT3 lower rectal cancer treated with preoperative chemoradiotherapy?

  • Atsushi Ogura
  • Takashi AkiyoshiEmail author
  • Noriko Yamamoto
  • Hiroshi Kawachi
  • Yuichi Ishikawa
  • Hisashi Noma
  • Masato Nagino
  • Yosuke Fukunaga
  • Masashi Ueno
Original Article
  • 251 Downloads

Abstract

Purpose

The prognostic significance of the depth of mesorectal invasion (DMI) in patients with ypT3 rectal cancer who undergo preoperative chemoradiotherapy (CRT) is unclear. The purpose of this study was to evaluate the prognostic significance of DMI in ypT3 rectal cancer.

Methods

A total of 168 (y)pT3 patients were evaluated, of whom 93 received preoperative CRT and 75 underwent surgery alone. Patients were subdivided into two groups according to the DMI (T3ab = DMI ≤5 mm and T3cd = DMI >5 mm). Oncologic outcomes were compared between the T3ab and T3cd groups and the ypT3ab and ypT3cd groups.

Results

Relapse-free survival was significantly different between the pT3ab and pT3cd groups (74.1 vs 38.5%, P = 0.0192) but not between the ypT3ab and ypT3cd groups (65.9 vs 61.5%, P = 0.513). Multivariate analysis showed that DMI was an independent predictor of recurrence in pT3 patients (hazard ratio [HR] = 2.980, 95% confidence interval [CI] 1.227–7.025; P = 0.0169) and that ypN+ was an independent predictor of recurrence in ypT3 patients (HR = 3.487, 95% CI 1.570–8.827; P = 0.0016).

Conclusions

DMI was not a significant predictive factor for recurrence in patients with ypT3 rectal cancer who underwent preoperative CRT, and ypN+ was the only independent predictive factor for recurrence.

Keywords

Depth of mesorectal invasion Rectal cancer Chemoradiotherapy ypT3 

Notes

Compliance with ethical standards

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Atsushi Ogura
    • 1
    • 2
  • Takashi Akiyoshi
    • 1
    Email author
  • Noriko Yamamoto
    • 3
  • Hiroshi Kawachi
    • 3
  • Yuichi Ishikawa
    • 3
  • Hisashi Noma
    • 4
  • Masato Nagino
    • 2
  • Yosuke Fukunaga
    • 1
  • Masashi Ueno
    • 1
  1. 1.Department of Gastroenterological SurgeryThe Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  3. 3.Division of PathologyThe Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
  4. 4.Department of Data ScienceThe Institute of Statistical MathematicsTokyoJapan

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