Long-term outcomes in ypT0 rectal cancers: An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO)

Laura Lorenzon, D. Parini, D. Rega, A. Mellano, V. Vigorita, A. Biondi, R. Jaminez-Rosellon, M. Scheiterle, Ivana Giannini, G. Gallo, G. Marino, Luca Turati, P. Marsanic, L. Franco, L. Marano, R. De Luca

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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 languageEnglish
JournalEuropean Journal of Surgical Oncology
DOIs
Publication statusPublished - Aug 2017

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Rectal Neoplasms
Adjuvant Chemotherapy
Recurrence
Multivariate Analysis
Survival
Colorectal Neoplasms
Therapeutics
Referral and Consultation
Retrospective Studies
Databases
Neoplasms

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 journalArticle

Lorenzon, L, Parini, D, Rega, D, Mellano, A, Vigorita, V, Biondi, A, Jaminez-Rosellon, R, Scheiterle, M, Giannini, I, Gallo, G, Marino, G, Turati, L, Marsanic, P, Franco, L, Marano, L & De Luca, R 2017, 'Long-term outcomes in ypT0 rectal cancers: An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO)', European Journal of Surgical Oncology. https://doi.org/10.1016/j.ejso.2017.04.017
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. / Long-term outcomes in ypT0 rectal cancers : An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO). In: European Journal of Surgical Oncology. 2017.
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title = "Long-term outcomes in ypT0 rectal cancers: An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO)",
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.",
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author = "Laura Lorenzon and D. Parini and D. Rega and A. Mellano and V. Vigorita and A. Biondi and R. Jaminez-Rosellon and M. Scheiterle and Ivana Giannini and G. Gallo and G. Marino and Luca Turati and P. Marsanic and L. Franco and L. Marano and {De Luca}, R.",
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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

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