Factors associated with local recurrence after neoadjuvant chemoradiation with total mesorectal excision for rectal cancer

Nam Kyu Kim, Young Wan Kim, Byung Soh Min, Kang Young Lee, Seung Kook Sohn, Chang Hwan Cho

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23 Citations (Scopus)

Abstract

Background: The purpose of the present study was to investigate risk factors associated with local recurrence in patients with locally advanced rectal cancer who received preoperative chemoradiotherapy in combination with total mesorectal excision (TME). Methods: Rectal cancer patients who were treated with neoadjuvant chemoradiation with TME were studied. We compared 26 patients who developed local recurrence with 119 recurrence-free patients during the follow-up period. Results: The median follow-up period was 52 months (range: 14-131 months). Based on the use of univariate and multivariate analyses, circumferential margin involvement (p = 0.02), the presence of lymphovascular or perineural invasion (p = 0.02), and positive nodal disease (p = 0.03) were contributing factors for local recurrence. The local recurrence rate was different between ypN(+) patients and ypN(-) patients with more than 12 nodes retrieved (p = 0.01). There was no difference in local recurrence rates between ypN(+) patients and ypN(-) patients with <12 nodes (p = 0.35) or between ypN(-) patients with <12 nodes or ≥12 nodes (p = 0.18). Conclusions: Patients with circumferential margin involvement, the presence of lymphovascular or perineural invasion, and positive nodal disease should be regarded as a high-risk group. We also determined that lymph node retrieval (<12 nodes) in patients with node-negative disease was a risk factor for local recurrence.

Original languageEnglish
Pages (from-to)1741-1749
Number of pages9
JournalWorld Journal of Surgery
Volume33
Issue number8
DOIs
Publication statusPublished - 2009 Aug 1

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Rectal Neoplasms
Recurrence
Chemoradiotherapy
Multivariate Analysis
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kim, Nam Kyu ; Kim, Young Wan ; Min, Byung Soh ; Lee, Kang Young ; Sohn, Seung Kook ; Cho, Chang Hwan. / Factors associated with local recurrence after neoadjuvant chemoradiation with total mesorectal excision for rectal cancer. In: World Journal of Surgery. 2009 ; Vol. 33, No. 8. pp. 1741-1749.
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abstract = "Background: The purpose of the present study was to investigate risk factors associated with local recurrence in patients with locally advanced rectal cancer who received preoperative chemoradiotherapy in combination with total mesorectal excision (TME). Methods: Rectal cancer patients who were treated with neoadjuvant chemoradiation with TME were studied. We compared 26 patients who developed local recurrence with 119 recurrence-free patients during the follow-up period. Results: The median follow-up period was 52 months (range: 14-131 months). Based on the use of univariate and multivariate analyses, circumferential margin involvement (p = 0.02), the presence of lymphovascular or perineural invasion (p = 0.02), and positive nodal disease (p = 0.03) were contributing factors for local recurrence. The local recurrence rate was different between ypN(+) patients and ypN(-) patients with more than 12 nodes retrieved (p = 0.01). There was no difference in local recurrence rates between ypN(+) patients and ypN(-) patients with <12 nodes (p = 0.35) or between ypN(-) patients with <12 nodes or ≥12 nodes (p = 0.18). Conclusions: Patients with circumferential margin involvement, the presence of lymphovascular or perineural invasion, and positive nodal disease should be regarded as a high-risk group. We also determined that lymph node retrieval (<12 nodes) in patients with node-negative disease was a risk factor for local recurrence.",
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Factors associated with local recurrence after neoadjuvant chemoradiation with total mesorectal excision for rectal cancer. / Kim, Nam Kyu; Kim, Young Wan; Min, Byung Soh; Lee, Kang Young; Sohn, Seung Kook; Cho, Chang Hwan.

In: World Journal of Surgery, Vol. 33, No. 8, 01.08.2009, p. 1741-1749.

Research output: Contribution to journalArticle

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AU - Kim, Young Wan

AU - Min, Byung Soh

AU - Lee, Kang Young

AU - Sohn, Seung Kook

AU - Cho, Chang Hwan

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