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

L Lorenzon, D Parini, D Rega, A Mellano, V Vigorita, A Biondi, R Jaminez-Rosellon, M Scheiterle, I Giannini, G Gallo, G Marino, L Turati, P Marsanic, L De Franco, L Marano, R De Luca, Senior SICO Supervising Members(1), Giuseppe La Torre

Research output: Contribution to journalArticle

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
Pages (from-to)1472-1480
Number of pages9
JournalEuropean Journal of Surgical Oncology
Volume43
Issue number8
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Italy
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Grading
  • Neoplasm Staging
  • Rectal Neoplasms
  • Retrospective Studies
  • Spain
  • Survival Analysis
  • Treatment Outcome
  • Journal Article
  • Multicenter Study

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    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., De Franco, L., Marano, L., De Luca, R., Senior SICO Supervising Members(1), & La Torre, G. (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, 43(8), 1472-1480. https://doi.org/10.1016/j.ejso.2017.04.017