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  • Title: Prognostic factors for low rectal cancer patients undergoing intersphincteric resection after neoadjuvant chemoradiation.
    Author: Lee SY, Jo JS, Kim HJ, Kim CH, Kim YJ, Kim HR.
    Journal: J Surg Oncol; 2015 Jun; 111(8):1054-8. PubMed ID: 25977149.
    Abstract:
    OBJECTIVES: This study aimed to investigate prognostic factors for low rectal cancer patients undergoing intersphincteric resection (ISR) following neoadjuvant chemoradiation (CRT). METHODS: We retrospectively reviewed 163 primary rectal cancer patients without distant metastasis who underwent ISR following neoadjuvant CRT between January 2006 and December 2011. Prognostic factors for disease-free survival (DFS) and local recurrence-free survival (LRFS) were evaluated. RESULTS: The median follow-up period was 53 months (range, 0-82 months). Kaplan-Meier survival analysis indicated different 3-year DFS (stage 0, 96.2%; I, 84.8%; II, 72.9%; III, 38.0%) and 3-year LRFS (stage 0, 100.0%; I, 92.4%; II, 91.1%; III, 70.9%) according to pathologic TNM stages, particularly stage III. Multivariable Cox regression analysis suggested that DFS was associated with ypT (3/4 vs. 0/1/2) and ypN (1/2 vs. 0) stages, whereas LRFS with ypN stage (1/2 vs. 0), tumor size (≥3.5 cm vs. <3.5 cm), and tumor height from the anal verge (≤2 cm vs. >2 cm). CONCLUSIONS: ISR following CRT could be feasible in stage-I and II low rectal cancer patients, but might be related to poor oncologic outcomes in those with stage-III disease. The indication for ISR or abdominoperineal resection should be carefully evaluated in cases of low rectal cancer with suspicious lymph node metastasis after CRT.
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