PMID- 21300482
OWN - NLM
STAT- MEDLINE
DCOM- 20120316
LR  - 20220331
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 82
IP  - 2
DP  - 2012 Feb 1
TI  - Stage-to-stage comparison of preoperative and postoperative chemoradiotherapy for 
      T3 mid or distal rectal cancer.
PG  - 856-62
LID - 10.1016/j.ijrobp.2010.10.079 [doi]
AB  - PURPOSE: To investigate, in a comparative analysis, the prognostic implications 
      of postchemoradiotherapy (post-CRT) pathologic stage (ypStage) vs. postoperative 
      pathologic stage (pStage) in rectal cancer. METHODS AND MATERIALS: Between May 
      2001 and December 2006, 487 patients with T3 mid or distal rectal cancer were 
      analyzed retrospectively. Concurrent CRT was administered preoperatively (n = 
      364, 74.7%) or postoperatively (n = 123, 25.3%). The radiation dose was 50.4 Gy 
      in 28 fractions. All patients underwent a total mesorectal excision and received 
      adjuvant chemotherapy. Disease-free survival (DFS) was estimated using the 
      Kaplan-Meier method. Differences in DFS, stratified by ypStage and pStage, were 
      compared using the log-rank test. RESULTS: For surviving patients, the median 
      follow-up period was 68 months (range, 12-105 months). The 5-year local 
      recurrence-free survival rate was not different, at 95.3% and 92.1% in 
      preoperative and postoperative CRT groups, respectively (p = 0.402), but the 
      5-year distant metastasis-free survival rate was significantly different, at 
      81.6% (preoperative CRT) vs. 65.4% (postoperative CRT; p = 0.001). The 5-year DFS 
      rate of 78.8% in the preoperative CRT group was significantly better than the 
      63.0% rate in the postoperative CRT group (p = 0.002). Post-CRT pathologic Stage 
      0-I occurred in 42.6% (155 of 364) of the patients with preoperative CRT. The 
      5-year DFS rates were 90.2% (ypStage 0-I), 83.5% (ypStage II), 77.3% (pStage II), 
      58.6% (ypStage III), and 54.7% (pStage III). The DFS rate of ypStage 0-I was 
      significantly better than that of ypStage II or pStage II. Post-CRT pathologic 
      Stage II and III had similar DFS, compared with pStage II and III, respectively. 
      CONCLUSIONS: Disease-free survival predicted by each ypStage was similar to that 
      predicted by the respective pStage. Improved DFS with preoperative vs. 
      postoperative CRT was associated with the ypStage 0-I group that showed a 
      similarly favorable outcome to pStage I rectal cancer.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Yeo, Seung-Gu
AU  - Yeo SG
AD  - Center for Colorectal Cancer, Research Institute and Hospital, National Cancer 
      Center, Goyang, Korea.
FAU - Kim, Dae Yong
AU  - Kim DY
FAU - Park, Ji Won
AU  - Park JW
FAU - Choi, Hyo Seong
AU  - Choi HS
FAU - Oh, Jae Hwan
AU  - Oh JH
FAU - Kim, Sun Young
AU  - Kim SY
FAU - Chang, Hee Jin
AU  - Chang HJ
FAU - Kim, Tae Hyun
AU  - Kim TH
FAU - Sohn, Dae Kyung
AU  - Sohn DK
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110206
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - 0W860991D6 (Deoxycytidine)
RN  - 6804DJ8Z9U (Capecitabine)
RN  - 7673326042 (Irinotecan)
RN  - Q573I9DVLP (Leucovorin)
RN  - U3P01618RT (Fluorouracil)
RN  - XT3Z54Z28A (Camptothecin)
SB  - IM
MH  - Adenocarcinoma/mortality/*pathology/*therapy
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Camptothecin/administration & dosage/analogs & derivatives
MH  - Capecitabine
MH  - Chemoradiotherapy/*methods/mortality
MH  - Chemotherapy, Adjuvant/methods
MH  - Deoxycytidine/administration & dosage/analogs & derivatives
MH  - Disease-Free Survival
MH  - Dose Fractionation, Radiation
MH  - Drug Administration Schedule
MH  - Female
MH  - Fluorouracil/administration & dosage/analogs & derivatives
MH  - Humans
MH  - Irinotecan
MH  - Leucovorin/administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging/methods
MH  - Postoperative Period
MH  - Preoperative Period
MH  - Prognosis
MH  - Rectal Neoplasms/mortality/*pathology/*therapy
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Time Factors
EDAT- 2011/02/09 06:00
MHDA- 2012/03/17 06:00
CRDT- 2011/02/09 06:00
PHST- 2010/06/12 00:00 [received]
PHST- 2010/09/17 00:00 [revised]
PHST- 2010/10/20 00:00 [accepted]
PHST- 2011/02/09 06:00 [entrez]
PHST- 2011/02/09 06:00 [pubmed]
PHST- 2012/03/17 06:00 [medline]
AID - S0360-3016(10)03701-6 [pii]
AID - 10.1016/j.ijrobp.2010.10.079 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2012 Feb 1;82(2):856-62. doi: 
      10.1016/j.ijrobp.2010.10.079. Epub 2011 Feb 6.