Shivnani Anand T, Small William, Stryker Steven J, Kiel Krystyna D, Lim Sherry, Halverson Amy L, Talamonti Mark S
Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Am J Surg. 2007 Mar;193(3):389-93; discussion 393-4. doi: 10.1016/j.amjsurg.2006.09.030.
Our goals were to examine the impact of neoadjuvant chemoradiation for rectal cancer on surgical outcomes and to determine prognostic factors predicting improved survival.
Retrospective cohort of 56 male and 44 female patients.
After preoperative chemoradiation, 73% of patients had sphincter-preserving surgery. The 5-year disease-free (DFS) and overall survival rates were 77% and 81%, respectively. Twenty-five percent of patients showed a complete pathologic response. T-level downstaging and pathologic T stage did not correlate with recurrence or survival rates. Pathologic nodal stage was associated with a significant difference in recurrence rates (N(0) 19%, N1 20%, and N2 75%, P = .038) and DFS (N0/N1 vs. N2, 79% vs. 25%, P = .002).
Neoadjuvant chemoradiation resulted in a high rate of sphincter preservation. Complete pathologic responses after surgery were frequent and although pathologic T stage after surgery did not affect recurrence rates, pathologic nodal response was associated with improved recurrence and survival rates.
我们的目标是研究直肠癌新辅助放化疗对手术结果的影响，并确定预测生存改善的预后因素。
对56例男性和44例女性患者进行回顾性队列研究。
术前放化疗后，73%的患者接受了保肛手术。5年无病生存率（DFS）和总生存率分别为77%和81%。25%的患者显示出完全病理缓解。T分期降期和术后病理T分期与复发率或生存率无关。病理淋巴结分期与复发率（N(0) 19%，N1 20%，N2 75%，P = 0.038）和DFS（N0/N1与N2，79%与25%，P = 0.002）存在显著差异。
新辅助放化疗导致保肛率较高。术后完全病理缓解常见，尽管术后病理T分期不影响复发率，但病理淋巴结反应与复发率和生存率的改善相关。
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