Kim Jun Gon, Song Kyoung Doo, Cha Dong Ik, Kim Hee Cheol, Yu Jeong Il
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
Int J Colorectal Dis. 2018 Oct;33(10):1359-1366. doi: 10.1007/s00384-018-3131-6. Epub 2018 Jul 13.
We compared the treatment outcome between surgery-first and neoadjuvant chemoradiation therapy (nCRT)-first strategies in patients with indistinguishable T2/T3-N0 rectal cancer on rectal magnetic resonance imaging (MRI).
Our institutional review board approved this retrospective study, and informed consent was waived. Among 1910 patients who underwent rectal MRI between 2008 and 2012, 79 patients (mean age, 59.4 years, 49 men and 30 women) who had indistinguishable T2/T3-N0 rectal cancer on rectal MRI were included. Local recurrence-free survival (LRFS), recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were compared between the two groups. Treatment-related complications were evaluated.
Among 79 patients, 51 were treated by surgery first and 28 were treated by nCRT first. In comparison of survival of the surgery- and nCRT-first groups at 5 years, the LRFS rate was 95.6 and 96.3%, RFS rate was 91.0 and 92.4%, OS rate was 93.7 and 92.6%, and DSS rate was 98.0 and 92.6%, respectively. LRFS, RFS, OS, and DSS showed no significant difference between the two groups (p = 0.862, 0.677, 0.953, and 0.479). The complication rate was not significantly different between the groups (20.0% for surgery-first group vs. 10.7% for nCRT-first group, p = 0.357).
Treatment outcomes were not significantly different between surgery-first and nCRT-first strategies for indistinguishable T2/T3-N0 rectal cancer on rectal MRI.
我们比较了在直肠磁共振成像（MRI）上T2/T3-N0期直肠癌难以区分的患者中，先手术和先新辅助放化疗（nCRT）两种策略的治疗效果。
我们的机构审查委员会批准了这项回顾性研究，并豁免了知情同意。在2008年至2012年间接受直肠MRI检查的1910例患者中，纳入了79例在直肠MRI上T2/T3-N0期直肠癌难以区分的患者（平均年龄59.4岁，49例男性和30例女性）。比较了两组的局部无复发生存率（LRFS）、无复发生存率（RFS）、总生存率（OS）和疾病特异性生存率（DSS）。评估了治疗相关并发症。
79例患者中，51例先接受手术治疗，28例先接受nCRT治疗。比较手术组和nCRT组5年生存率，LRFS率分别为95.6%和96.3%，RFS率分别为91.0%和92.4%，OS率分别为93.7%和92.6%，DSS率分别为98.0%和92.6%。两组的LRFS、RFS、OS和DSS均无显著差异（p = 0.862、0.677、0.953和0.479）。两组并发症发生率无显著差异（先手术组为20.0%，先nCRT组为10.7%，p = 0.357）。
对于在直肠MRI上难以区分的T2/T3-N0期直肠癌，先手术和先nCRT两种策略的治疗效果无显著差异。
