Abstract
Aim: To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. Methods: Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes. All clinical and pathological variables were reviewed. Univariate and multivariate analyses were conducted with the end-point of survivals. Results: Two hundreds and sixty-one patients were analyzed including 237 ypT0 and 24 ypTis. Nodal positive patients were 8.7%. More than sixty-six percent of the patients did not perform adjuvant chemotherapy, with a statistical difference comparing N0 versus N+ patients (66.8% vs 40.9%, p 0.02). Mean follow-up was of 47.6 months. Twenty-two relapses were observed, 91.6% at a distant site. The mean time to recurrence was of 35.3 months. On univariate analysis, the use of adjuvant chemotherapy correlated with better OS exclusively in ypT0N + patients and not in ypT0N0. Univariate and multivariate analyses documented nodal positivity as the only prognostic factor correlated with a worse OS. Conclusion: Recurrences were mostly diagnosed at a distant site and within the third year of follow-up. Nodal positivity was the only variable independently correlated with a worse OS. Univariate analysis documented a benefit for the use of adjuvant chemotherapy treatment exclusively in ypT0N + rectal cancers.
| Original language | English |
|---|---|
| Journal | European Journal of Surgical Oncology |
| DOIs | |
| Publication status | Published - Aug 2017 |
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Keywords
- Neo-adjuvant treatment
- Pathologic complete response
- Rectal cancer
- YpT0
ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
Long-term outcomes in ypT0 rectal cancers : An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO). / Lorenzon, Laura; Parini, D.; Rega, D.; Mellano, A.; Vigorita, V.; Biondi, A.; Jaminez-Rosellon, R.; Scheiterle, M.; Giannini, Ivana; Gallo, G.; Marino, G.; Turati, Luca; Marsanic, P.; Franco, L.; Marano, L.; De Luca, R.
In: European Journal of Surgical Oncology, 08.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term outcomes in ypT0 rectal cancers
T2 - An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO)
AU - Lorenzon, Laura
AU - Parini, D.
AU - Rega, D.
AU - Mellano, A.
AU - Vigorita, V.
AU - Biondi, A.
AU - Jaminez-Rosellon, R.
AU - Scheiterle, M.
AU - Giannini, Ivana
AU - Gallo, G.
AU - Marino, G.
AU - Turati, Luca
AU - Marsanic, P.
AU - Franco, L.
AU - Marano, L.
AU - De Luca, R.
PY - 2017/8
Y1 - 2017/8
N2 - Aim: To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. Methods: Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes. All clinical and pathological variables were reviewed. Univariate and multivariate analyses were conducted with the end-point of survivals. Results: Two hundreds and sixty-one patients were analyzed including 237 ypT0 and 24 ypTis. Nodal positive patients were 8.7%. More than sixty-six percent of the patients did not perform adjuvant chemotherapy, with a statistical difference comparing N0 versus N+ patients (66.8% vs 40.9%, p 0.02). Mean follow-up was of 47.6 months. Twenty-two relapses were observed, 91.6% at a distant site. The mean time to recurrence was of 35.3 months. On univariate analysis, the use of adjuvant chemotherapy correlated with better OS exclusively in ypT0N + patients and not in ypT0N0. Univariate and multivariate analyses documented nodal positivity as the only prognostic factor correlated with a worse OS. Conclusion: Recurrences were mostly diagnosed at a distant site and within the third year of follow-up. Nodal positivity was the only variable independently correlated with a worse OS. Univariate analysis documented a benefit for the use of adjuvant chemotherapy treatment exclusively in ypT0N + rectal cancers.
AB - Aim: To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. Methods: Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes. All clinical and pathological variables were reviewed. Univariate and multivariate analyses were conducted with the end-point of survivals. Results: Two hundreds and sixty-one patients were analyzed including 237 ypT0 and 24 ypTis. Nodal positive patients were 8.7%. More than sixty-six percent of the patients did not perform adjuvant chemotherapy, with a statistical difference comparing N0 versus N+ patients (66.8% vs 40.9%, p 0.02). Mean follow-up was of 47.6 months. Twenty-two relapses were observed, 91.6% at a distant site. The mean time to recurrence was of 35.3 months. On univariate analysis, the use of adjuvant chemotherapy correlated with better OS exclusively in ypT0N + patients and not in ypT0N0. Univariate and multivariate analyses documented nodal positivity as the only prognostic factor correlated with a worse OS. Conclusion: Recurrences were mostly diagnosed at a distant site and within the third year of follow-up. Nodal positivity was the only variable independently correlated with a worse OS. Univariate analysis documented a benefit for the use of adjuvant chemotherapy treatment exclusively in ypT0N + rectal cancers.
KW - Neo-adjuvant treatment
KW - Pathologic complete response
KW - Rectal cancer
KW - YpT0
UR - http://www.scopus.com/inward/record.url?scp=85019714351&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019714351&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2017.04.017
DO - 10.1016/j.ejso.2017.04.017
M3 - Article
AN - SCOPUS:85019714351
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
ER -