Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
Department of Medicine, Loyola University Medical Center, Maywood, IL, USA.
Am J Surg. 2014 Mar;207(3):357-60; discussion 360. doi: 10.1016/j.amjsurg.2013.09.011. Epub 2013 Dec 19.
To determine if patients with clinical stage III rectal cancer treated with neoadjuvant chemoradiotherapy (CRT) and surgery have an improved survival when the response to treatment results in a pathologic T3 tumor with a microscopic focus (≤5 mm) compared with a larger (>5 mm) invasion of the perirectal tissue.
A retrospective review was conducted of 56 consecutive patients clinically diagnosed as T3N1M0 rectal cancer before treatment, who completed neoadjuvant CRT followed by surgical resection. Those with residual pathologic T3 disease (n = 28) were analyzed separately. Clinicopathologic data including T stage, lymph node status, k-ras status, and differentiation were reviewed.
Among all 56 patients, there was no identified predictor of survival following neoadjuvant CRT and surgery. Among those with residual T3 disease, tumors extending >5 mm invasion into the perirectal tissue were associated with a higher risk of recurrence (50% vs 17%) and worse overall survival (4.3 vs 6.8 years, P = .015) when compared to tumors with ≤5 mm invasion into the perirectal tissue.
The depth of residual T3 tumor invasion into the perirectal tissue correlates with recurrence and overall survival in patients who underwent neoadjuvant therapy followed by surgical resection for clinically staged T3N1M0 rectal cancer.
为了确定接受新辅助放化疗（CRT）和手术治疗的临床 III 期直肠癌患者，如果治疗反应导致病理 T3 肿瘤有微小焦点（≤5mm）的浸润，与更大（>5mm）的直肠周围组织浸润相比，生存是否得到改善。
对 56 例临床诊断为 T3N1M0 直肠癌的患者进行回顾性分析，这些患者在接受新辅助 CRT 后接受了手术切除。对有残留病理 T3 疾病的患者（n=28）进行单独分析。对临床病理数据包括 T 分期、淋巴结状态、k-ras 状态和分化进行了回顾。
在所有 56 例患者中，没有发现新辅助 CRT 和手术后生存的预测因素。在有残留 T3 疾病的患者中，肿瘤向直肠周围组织的侵犯>5mm 与更高的复发风险（50%比 17%）和更差的总生存（4.3 比 6.8 年，P=0.015）相关，与侵犯直肠周围组织≤5mm 的肿瘤相比。
在接受新辅助治疗后接受手术切除的临床分期为 T3N1M0 直肠癌患者中，残留 T3 肿瘤侵犯直肠周围组织的深度与复发和总生存相关。
