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Original Article
- Oncologic Outcomes of Postoperative Chemoradiotherapy Versus Chemotherapy Alone in Stage II and III Upper Rectal Cancer
- Ji Eun Yoon, Soo Young Lee, Han Duk Kwak, Seung Seop Yeom, Chang Hyun Kim, Jae Kyun Joo, Hyeong Rok Kim, Young Jin Kim
- Ann Coloproctol. 2019;35(3):137-143. Published online June 30, 2019
- DOI: https://doi.org/10.3393/ac.2018.09.28
- 6,809 View
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- 6 Web of Science
- 7 Citations
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Abstract
PDF - Purpose
The aim of this study was to assess oncological outcomes of postoperative radiotherapy plus chemotherapy (CRT) versus chemotherapy alone (CTx) in stage II or III upper rectal cancer patients who underwent curative surgery.
Methods
We retrospectively reviewed 263 consecutive patients with pathologic stage II or III upper rectal cancer who underwent primary curative resection with postoperative CRT or CTx from January 2008 to December 2014 at Chonnam National University Hwasun Hospital. Multivariate and propensity score matching analyses were used to reduce selection bias.
Results
Median follow-up was 48.1 months for the entire cohort and 53.5 months for the matched cohort. In subgroup analysis of the propensity score matched cohort, the 3-year local recurrence-free survival was 94.1% (95% confidence interval [CI], 87.8%–100%) in the CRT group and 90.1% (95% CI, 82.8%–97.9%) in the CTx group (P = 0.370). No significant difference in disease-free survival was observed according to treatment type. On multivariate analysis, circumferential resection margin involvement (hazard ratio [HR], 2.386; 95% CI, 1.190–7.599; P = 0.032), N stage (HR, 6.262; 95% CI, 1.843–21.278, P = 0.003), and T stage (HR, 5.896, 95% CI, 1.298–6.780, P = 0.021) were identified as independent risk factors for local recurrence of tumors of the upper rectum.
Conclusion
Omission of radiotherapy in an adjuvant treatment setting may not jeopardize oncologic outcomes in stages II and III upper rectal cancer. -
Citations
Citations to this article as recorded by
- Executive Summary of the American Radium Society Appropriate Use Criteria for Selective Use of Pelvic Radiation Therapy in Locally Advanced Rectal Cancer: A Consensus Statement
Leila T Tchelebi, Krishan R. Jethwa, Eric Dozios, Zhaohui Jin, Gwen Wilson, Christopher J. Anker, Gerard Abood, Dmitriy Akselrod, Joseph Attallah, D. Chamil Codipilly, Christopher L. Hallemeier, Timothy Kennedy, Percy Lee, Diane C. Ling, Eric D. Miller, N
International Journal of Radiation Oncology*Biology*Physics.2026;[Epub] CrossRef - Efficacies of radiotherapy in rectal cancer patients treated with total mesorectal excision or other types of surgery: an updated meta-analysis
Wenshu Wang, Runyuan Zhao, Xi Liang, Manjun Liu, Haiyan Bai, Jianli Ge, Binxi Yao, Zheng Zhi, Jianming He
Oncology Reviews.2025;[Epub] CrossRef - Is neoadjuvant chemoradiotherapy necessary for locally advanced rectal cancer above the anterior peritoneal reflection?
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Future Oncology.2025; 21(28): 3667. CrossRef - The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement
Sean J. Langenfeld, Bradley R. Davis, Jon D. Vogel, Jennifer S. Davids, Larissa K.F. Temple, Kyle G. Cologne, Samantha Hendren, Steven Hunt, Julio Garcia Aguilar, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Diseases of the Colon & Rectum.2024; 67(1): 18. CrossRef - Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients
Zhiwei Ma, Jumei Zhou, Ke Liu, Sisi Chen, Qinghui Wu, Lin Peng, Wei Zhao, Suyu Zhu
Radiation Oncology.2024;[Epub] CrossRef - Which Definition of Upper Rectal Cancer Is Optimal in Selecting Stage II or III Rectal Cancer Patients to Avoid Postoperative Adjuvant Radiation?
Xian Hua Gao, Bai Zhi Zhai, Juan Li, Jean Luc Tshibangu Kabemba, Hai Feng Gong, Chen Guang Bai, Ming Lu Liu, Shao Ting Zhang, Fu Shen, Lian Jie Liu, Wei Zhang
Frontiers in Oncology.2021;[Epub] CrossRef - Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis
Xin-qi Shi, Jing-yu Zhang, Hua Tian, Ling-na Tang, Ai-lin Li
Journal of Zhejiang University-SCIENCE B.2020; 21(7): 549. CrossRef
- Executive Summary of the American Radium Society Appropriate Use Criteria for Selective Use of Pelvic Radiation Therapy in Locally Advanced Rectal Cancer: A Consensus Statement
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