Abstract:
PURPOSE:The clinical implications of mucinous components in rectal tumors, especially with regard to the efficacy of neoadjuvant chemoradiotherapy, remain unclear. METHODS:One hundred and thirty rectal cancer patients who received curative resection after neoadjuvant chemoradiotherapy were retrospectively reviewed. Patients were classified into 3 groups according to the proportion of extracellular mucin: low (<5 %), moderate (5-25 %), and high (>25 %). RESULTS:There were 82 (63.1 %), 26 (20.0 %), and 22 (16.9 %) patients in the low, moderate, and high mucin groups, respectively. Patients with a high mucinous tumor component were significantly more likely to have an advanced tumor stage (p = 0.010) and a shorter disease-free (p = 0.002) and distant recurrence-free survivals (p < 0.001), whereas the mucinous tumor component showed no correlation with local recurrence (p = 0.101). A high mucinous component was also an independent predictive factor for a shorter disease-free survival (p = 0.041, hazard ratio = 2.56) and distant recurrence-free survival (p = 0.001, hazard ratio = 5.74) according to a multivariate analysis. CONCLUSIONS:Because the mucinous components showed little correlation with local recurrence, mucinous cancer should not be a determining factor for chemoradiotherapy. However, the frequent occurrence of metachronous distant metastasis among patients with a high mucin component makes this a possible indicator for more robust postoperative adjuvant treatment and close surveillance of recurrence.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Kaneko K,Kawai K,Kazama S,Murono K,Sasaki K,Yasuda K,Ohtani K,Nishikawa T,Tanaka T,Kiyomatsu T,Hata K,Nozawa H,Ishihara S,Morikawa T,Fukayama M,Watanabe Tdoi
10.1007/s00595-016-1419-0subject
Has Abstractpub_date
2017-06-01 00:00:00pages
697-704issue
6eissn
0941-1291issn
1436-2813pii
10.1007/s00595-016-1419-0journal_volume
47pub_type
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