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- Loftås, PerLinköpings universitet,Avdelningen för kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken ViN (author)
Nodal involvement in luminal complete response after neoadjuvant treatment for rectal cancer
- Article/chapterEnglish2016
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- ELSEVIER SCI LTD,2016
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- LIBRIS-ID:oai:DiVA.org:liu-130432
- https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-130432URI
- https://doi.org/10.1016/j.ejso.2016.03.013DOI
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- Language:English
- Summary in:English
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- Background: Pathological complete response (pCR) after neoadjuvant therapy in rectal cancer is correlated with improved survival. There is limited knowledge on the incidence of pCR at a national level with uniform guidelines. The aim of this prospective register-based study was to investigate the incidence and outcome of pCR in relation to neoadjuvant therapy in a national cohort. Method: All patients abdominally operated for rectal cancer between 2007 and 2012 (n = 7885) were selected from The Swedish Colorectal Cancer Register. Twenty-six per cent (n = 2063) had neoadjuvant therapy with either long or short course radiotherapy with amp;gt;4 weeks delay with the potential to achieve pCR. The primary endpoints were pCR and survival in relation to neoadjuvant therapy. Results: Complete eradication of the luminal tumor, ypTO was found in 161 patients (8%). In 83% of the ypTO the regional lymph nodes were tumor negative (ypTONO), 12% had 1-3 positive lymph nodes (ypTON1) and 4% had more than three positive lymph nodes (ypTON2). There was significantly greater survival with ypTO compared to ypT+ (hazard ratio 0.38 (C.I 0.25-0.58)) and survival was significantly greater in patients with ypTONO compared to ypT0N1-2 (hazard ratio 0.36 (C.I 0.15-0.86)). In ypTO, cT3-4 tumors had the greater risk of node-positivity. The added use of chemotherapy resulted in 10% ypTO compared to 5.1% in the group without chemotherapy (p amp;lt; 0.00004). Conclusion: Luminal pathological complete response occurred in 8%, 16% of them had tumor positive nodes. The survival benefit of luminal complete response is dependent upon nodal involvement status. (C) 2016 Elsevier Ltd. All rights reserved.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
- Rectal cancer; Complete response; Lymph nodes; Neoadjuvant treatment
Added entries (persons, corporate bodies, meetings, titles ...)
- Arbman, GunnarLinköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Region Östergötland, Kirurgiska kliniken ViN(Swepub:liu)gunar63 (author)
- Fomichov Casaballe, VictoriaLinköpings universitet,Institutionen för medicin och hälsa,Medicinska fakulteten,Region Östergötland, Regionalt cancercentrum(Swepub:liu)vicfo67 (author)
- Hallböök, OlofLinköpings universitet,Avdelningen för kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US(Swepub:liu)oloha72 (author)
- Linköpings universitetAvdelningen för kliniska vetenskaper (creator_code:org_t)
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- In:European Journal of Surgical Oncology: ELSEVIER SCI LTD42:6, s. 801-8070748-79831532-2157
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