Quality of surgery in T3-4 rectal cancer: involvement of circumferential resection margin not influenced by preoperative treatment. Results from EORTC trial 22921.
作者信息
den Dulk Marcel, Collette Laurence, van de Velde Cornelis J H, Marijnen Corrie A M, Calais Gilles, Mineur Laurent, Maingon Phillippe, Radosevic-Jelic Ljiljana, Daban Alain, Bosset Jean-Francois
机构信息
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
出版信息
Eur J Cancer. 2007 Aug;43(12):1821-8. doi: 10.1016/j.ejca.2007.05.025. Epub 2007 Jul 12.
PURPOSE
The present analyses aimed to determine risk factors for rectal cancer patients associated with circumferential resection margin (CRM) and number of examined lymph nodes (LN) and to correlate these parameters of surgical quality with local recurrence (LR), disease-free and overall survival (DFS and OS).
MATERIALS AND METHODS
Data of 884 eligible patients, who underwent a resection and had no metastases at time of surgery, were analysed.
RESULTS
Age, period of treatment, distance and pT-stage were associated with surgical quality. CRM involvement, but not the number of examined LN, was associated with a higher risk of an LR, reduced DFS and OS. An abdomino-perineal resection (APR) was a risk factor for adverse outcome.
CONCLUSION
Surgical quality is an important predictor of outcome, also for patients treated with conventional RT or chemoradiotherapy (CRT). Preoperative CRT results in downstaging and downsizing of the tumour, but not in less CRM involvement.
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