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Article: Outcome of neoadjuvant chemoradiation in MRI staged locally advanced rectal cancer: Retrospective analysis of 123 Chinese patients

TitleOutcome of neoadjuvant chemoradiation in MRI staged locally advanced rectal cancer: Retrospective analysis of 123 Chinese patients
Authors
KeywordsChemoradiotherapy
Magnetic resonance imaging
Rectal neoplasms
Survival
Issue Date2018
PublisherElsevier (Singapore) Pte Ltd, Hong Kong Branch. The Journal's web site is located at http://www.elsevier.com/locate/inca/708700
Citation
Journal of the Formosan Medical Association, 2018, v. 117 n. 9, p. 825-832 How to Cite?
AbstractBackground: For advanced rectal cancer with involved or threatened mesorectal fascia (MRF), current standard is pre-operative long course chemoradiotherapy (PLCRT) with either capecitabine or 5-fluorouracil (5-FU). However, few Chinese data on its clinical outcome are available, especially for those with pelvic MRI staging. Methods: Between Jan-2009 and Oct-2014, 123 consecutive patients with biopsy proven adenocarcinoma of rectum, all with pelvic MRI staging, selected for PLCRT after multi-disciplinary team discussion were recruited. Their clinical records were retrospectively reviewed. Results: Median follow-up was 1392 days (range: 48–2886) MRI defined poor risk factors as follows: MRF threatened or involved ≤1 mm 61.8% (n = 76), cT4 13.8% (n = 17), cN2 26.8% (n = 33) and low-lying tumor (≤5 cm from anal verge) 24.4% (n = 30). Five year OS and DFS were 63.9% and 68.3% respectively. Among 112 patients who received TME, 108 (96.4%) had microscopic clear resection (R0). Twelve and 32 individuals had pathological complete response and ypT0-2N0, respectively. Five local recurrences (4.5%) were detected. The incidence of grade 3 or above acute and late radiotherapy toxicity was 8.1% and 12.2% respectively. After multivariate adjustment, positive circumferential resection margin (CRM) status on pathology report was found to be significant factor for worse OS and DFS. Conclusion: The clinical outcomes of PLCRT in our institution are comparable with those in western literature. Our MRI staging lends support to the validity of data. CRM status is the most significant prognostic factor in OS and DFS, after multivariate adjustment.
Persistent Identifierhttp://hdl.handle.net/10722/251785
ISSN
2021 Impact Factor: 3.871
2020 SCImago Journal Rankings: 0.708
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, SF-
dc.contributor.authorChiang, CL-
dc.contributor.authorLee, FAS-
dc.contributor.authorWong, YW-
dc.contributor.authorPoon, CMM-
dc.contributor.authorWong, CSF-
dc.contributor.authorTung, SY-
dc.date.accessioned2018-03-19T07:01:12Z-
dc.date.available2018-03-19T07:01:12Z-
dc.date.issued2018-
dc.identifier.citationJournal of the Formosan Medical Association, 2018, v. 117 n. 9, p. 825-832-
dc.identifier.issn0929-6646-
dc.identifier.urihttp://hdl.handle.net/10722/251785-
dc.description.abstractBackground: For advanced rectal cancer with involved or threatened mesorectal fascia (MRF), current standard is pre-operative long course chemoradiotherapy (PLCRT) with either capecitabine or 5-fluorouracil (5-FU). However, few Chinese data on its clinical outcome are available, especially for those with pelvic MRI staging. Methods: Between Jan-2009 and Oct-2014, 123 consecutive patients with biopsy proven adenocarcinoma of rectum, all with pelvic MRI staging, selected for PLCRT after multi-disciplinary team discussion were recruited. Their clinical records were retrospectively reviewed. Results: Median follow-up was 1392 days (range: 48–2886) MRI defined poor risk factors as follows: MRF threatened or involved ≤1 mm 61.8% (n = 76), cT4 13.8% (n = 17), cN2 26.8% (n = 33) and low-lying tumor (≤5 cm from anal verge) 24.4% (n = 30). Five year OS and DFS were 63.9% and 68.3% respectively. Among 112 patients who received TME, 108 (96.4%) had microscopic clear resection (R0). Twelve and 32 individuals had pathological complete response and ypT0-2N0, respectively. Five local recurrences (4.5%) were detected. The incidence of grade 3 or above acute and late radiotherapy toxicity was 8.1% and 12.2% respectively. After multivariate adjustment, positive circumferential resection margin (CRM) status on pathology report was found to be significant factor for worse OS and DFS. Conclusion: The clinical outcomes of PLCRT in our institution are comparable with those in western literature. Our MRI staging lends support to the validity of data. CRM status is the most significant prognostic factor in OS and DFS, after multivariate adjustment.-
dc.languageeng-
dc.publisherElsevier (Singapore) Pte Ltd, Hong Kong Branch. The Journal's web site is located at http://www.elsevier.com/locate/inca/708700-
dc.relation.ispartofJournal of the Formosan Medical Association-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectChemoradiotherapy-
dc.subjectMagnetic resonance imaging-
dc.subjectRectal neoplasms-
dc.subjectSurvival-
dc.titleOutcome of neoadjuvant chemoradiation in MRI staged locally advanced rectal cancer: Retrospective analysis of 123 Chinese patients-
dc.typeArticle-
dc.identifier.emailChiang, CL: chiangcl@hku.hk-
dc.identifier.authorityChiang, CL=rp02241-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.jfma.2017.10.002-
dc.identifier.pmid29100742-
dc.identifier.scopuseid_2-s2.0-85032945298-
dc.identifier.hkuros284458-
dc.identifier.volume117-
dc.identifier.issue9-
dc.identifier.spage825-
dc.identifier.epage832-
dc.identifier.isiWOS:000442516100009-
dc.publisher.placeHong Kong-
dc.identifier.issnl0929-6646-

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