Treder Maxi, Vogelsang Rasmus Peuliche, Janssen Stefan, Schild Steven E, Holländer Niels Henrik, Rades Dirk
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Department of Surgery, Zealand University Hospital, Køge, Denmark.
In Vivo. 2018 Nov-Dec;32(6):1481-1484. doi: 10.21873/invivo.11403.
BACKGROUND/AIM: Treatment for high rectal cancers, particularly the value of preoperative treatment, is controversial. In our previous study, downstaging by preoperative chemoradiation resulted in improved outcomes. The aim of the present study was to identify prognostic factors to predict which patients will achieve downstaging and may benefit from preoperative treatment.
In 54 patients with locally advanced non-metastatic high rectal cancer, 8 factors were evaluated for downstaging by preoperative chemoradiation including age, gender, carcinoembryonic antigen level, performance status, T-/N-category, UICC-stage (Union for International Cancer Control) and histological grade. Downstaging was defined as decrease by at least one UICC-stage.
Downstaging was achieved in 36 patients (67%). Patients at UICC-stage III showed a trend for downstaging.
The majority of patients with UICC-stage III tumors were downstaged and appear to benefit from preoperative chemoradiation. In general, the potential value of preoperative treatment for high rectal cancers needs further investigation.
背景/目的：高位直肠癌的治疗，尤其是术前治疗的价值，存在争议。在我们之前的研究中，术前放化疗使肿瘤降期从而改善了预后。本研究的目的是确定预后因素，以预测哪些患者能够实现肿瘤降期并可能从术前治疗中获益。
在54例局部晚期非转移性高位直肠癌患者中，评估了8个因素对术前放化疗肿瘤降期的影响，这些因素包括年龄、性别、癌胚抗原水平、体能状态、T/N分期、国际癌症控制联盟（UICC）分期和组织学分级。肿瘤降期定义为UICC分期至少降低一期。
36例患者（67%）实现了肿瘤降期。UICC III期患者呈现出肿瘤降期的趋势。
大多数UICC III期肿瘤患者实现了肿瘤降期，似乎从术前放化疗中获益。总体而言，高位直肠癌术前治疗的潜在价值需要进一步研究。
