Does the depth of mesorectal invasion have prognostic significance in patients with ypT3 lower rectal cancer treated with preoperative chemoradiotherapy?
- 251 Downloads
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.
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.
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).
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.
KeywordsDepth of mesorectal invasion Rectal cancer Chemoradiotherapy ypT3
Compliance with ethical standards
Conflict of interest statement
The authors declare that they have no conflict of interest.
- 1.Merkel S, Mansmann U, Siassi M, Papadopoulos T, Hohenberger W, Hermanek P (2001) The prognostic inhomogeneity in pT3 rectal carcinomas. Int J Color Dis 16:298–304Google Scholar
- 2.Akagi Y, Shirouzu K, Fujita S, Ueno H, Takii Y, Komori K, Ito M, Sugihara K, Study Group of the Japanese Society for Cancer of the Colon and Rectum (JSCCR) on the Clinical Significance of the Mesorectal Extension of Rectal Cancer (2012) Predicting oncologic outcomes by stratifying mesorectal extension in patients with pT3 rectal cancer: a Japanese multi-institutional study. Int J Cancer 131:1220–1227CrossRefPubMedGoogle Scholar
- 4.Shirouzu K, Akagi Y, Fujita S, Ueno H, Takii Y, Komori K, Ito M, Sugihara K, Japanese Society for Cancer of the Colon and Rectum (JSCCR) on Clinical Significance of the Mesorectal Extension of Rectal Cancer (2011) Clinical significance of the mesorectal extension of rectal cancer: a Japanese multi-institutional study. Ann Surg 253:704–710CrossRefPubMedGoogle Scholar
- 9.Taylor FG, Quirke P, Heald RJ, Moran B, Blomqvist L, Swift I, Sebag-Montefiore DJ, Tekkis P, Brown G, MERCURY study group (2011) Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg 253:711–719CrossRefPubMedGoogle Scholar
- 11.Gosens MJ, Klaassen RA, Tan-Go I, Rutten HJ, Martijn H, van den Brule AJ, Nieuwenhuijzen GA, van Krieken JH, Nagtegaal ID (2007) Circumferential margin involvement is the crucial prognostic factor after multimodality treatment in patients with locally advanced rectal carcinoma. Clin Cancer Res 13:6617–6623CrossRefPubMedGoogle Scholar
- 13.Moon SH, Kim DY, Park JW, Oh JH, Chang HJ, Kim SY, Kim TH, Park HC, Choi DH, Chun HK, Kim JH, Park JH, Yu CS (2012) Can the new American Joint Committee on Cancer staging system predict survival in rectal cancer patients treated with curative surgery following preoperative chemoradiotherapy? Cancer 118:4961–4968CrossRefPubMedGoogle Scholar