Abstract:
BACKGROUND:Neoadjuvant chemoradiotherapy (CRT) followed by radical surgery including total mesorectal excision (TME) is standard treatment in patients with locally advanced rectal cancer. Emerging data indicate that patients with complete pathologic response (ypCR) after CRT have favorable outcome, suggesting the possibility of less invasive surgical treatment. We analyzed long-term outcome of cT3 rectal cancer treated by neoadjuvant CRT in relation to ypCR and type of surgery. METHODS:The study population comprised 139 patients (93 men, 46 women; median age 62 years) with cT3N0-1M0 mid and distal rectal adenocarcinoma treated by CRT and surgery (110 TME and 29 local excision) at our institution between 1996 and 2008. At pathology, ypCR was defined as no residual cancer cells in the primary tumor. RESULTS:Tumors of 42 patients (30.2%) were classified as ypCR. After a median follow-up of 55.4 months, comparing patients with ypCR to patients with no ypCR, 5-year disease-specific survival was 95.8% versus 78.0% (P = 0.004), and 5-year disease-free survival was 90.1% vs. 64.0% (P = 0.004). In patients with ypCR, no statistically significant outcome difference was observed between TME and local excision. In patients treated by local excision, comparing patients with ypCR to patients with no ypCR, 5-year disease-free survival was 100% vs. 65.5% (P = 0.024), and 5-year local recurrence-free survival was 92.9% vs. 66.7% (P = 0.047). CONCLUSIONS:With retrospective analysis limitations, our data confirm favorable long-term outcome of cT3 rectal cancer with ypCR after CRT and warrant clinical trials exploring local excision surgical strategies.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Belluco C,De Paoli A,Canzonieri V,Sigon R,Fornasarig M,Buonadonna A,Boz G,Innocente R,Perin T,Cossaro M,Polesel J,De Marchi Fdoi
10.1245/s10434-011-1822-0subject
Has Abstractpub_date
2011-12-01 00:00:00pages
3686-93issue
13eissn
1068-9265issn
1534-4681journal_volume
18pub_type
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1163-4
更新日期:2010-12-01 00:00:00
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
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更新日期:2016-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
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更新日期:2013-08-01 00:00:00
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journal_title:Annals of surgical oncology
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更新日期:2012-02-01 00:00:00
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
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更新日期:2018-12-01 00:00:00
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
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更新日期:2020-06-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2014-12-01 00:00:00
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journal_title:Annals of surgical oncology
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更新日期:2007-05-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2007-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1159-0
更新日期:2010-11-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2019-02-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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更新日期:2011-01-01 00:00:00
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2014-03-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4713-y
更新日期:2015-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:With cholangiocarcinoma, the only hope of a cure is resection. This study was undertaken to determine the impact of margin status, stage, tumor location, and adjuvant therapy on survival after resection of extrahepatic cholangiocarcinoma. METHODS:From 1985-2006, 91 patients underwent resections of cholangio...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9756-2
更新日期:2008-03-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6354-4
更新日期:2018-05-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2010-04-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2020-07-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-08-01 00:00:00