Takeda Mitsumasa, Kawahara Hidejiro, Ogawa Masaichi, Suwa Katsuhito, Eto Ken, Yanaga Katsuhiko
Department of Surgery, Kashiwa Hospital, the Jikei University School of Medicine, Chiba, Japan.
Department of Surgery, Kashiwa Hospital, the Jikei University School of Medicine, Chiba, Japan
Anticancer Res. 2019 Jun;39(6):3047-3052. doi: 10.21873/anticanres.13438.
This study aimed to re-evaluate the usefulness of preoperative chemoradiotherapy for clinical T3 lower rectal cancers without lateral lymph node metastasis.
Between 2010 and 2014, 132 patients with clinical T3 lower rectal cancer without lateral lymph node metastasis, 80 years of age or younger, who underwent curative resection at four Jikei University Hospitals were enrolled into this retrospective study. Of these, 22 patients received chemoradiotherapy (CRT) before surgery, 16 patients received intensive chemotherapy after surgery without preoperative CRT, and 94 patients underwent neither preoperative CRT nor intensive chemotherapy after surgery including 47 patients with postoperative oral chemotherapy for pathological diagnosis of stage III.
The 3-year disease-free survival (DFS) of the 22 patients who received preoperative CRT was 95.5%, whereas that of the 94 patients who received neither preoperative CRT nor intensive chemotherapy was 72.0% (p=0.024). However, there was no significant difference in 5-year DFS between the two groups. No significant difference was identified in DFS between the 22 patients who received preoperative CRT and the 16 patients who received intensive chemotherapy after surgery without preoperative CRT.
Intensive chemotherapy after surgery seems to yield a similar prognosis to preoperative CRT in patients with clinical T3 lower rectal cancer without lateral lymph node metastasis.
本研究旨在重新评估术前放化疗对无侧方淋巴结转移的临床T3期低位直肠癌的有效性。
2010年至2014年期间，132例年龄80岁及以下、无侧方淋巴结转移的临床T3期低位直肠癌患者在四所慈惠会医科大学附属医院接受了根治性切除术，并纳入本回顾性研究。其中，22例患者在手术前接受了放化疗（CRT），16例患者在手术后接受了强化化疗但未进行术前CRT，94例患者既未接受术前CRT也未在术后接受强化化疗，其中47例患者术后接受口服化疗以进行III期病理诊断。
接受术前CRT的22例患者的3年无病生存率（DFS）为95.5%，而既未接受术前CRT也未接受强化化疗的94例患者的3年无病生存率为72.0%（p=0.024）。然而，两组的5年DFS无显著差异。接受术前CRT的22例患者与术后接受强化化疗但未进行术前CRT的16例患者之间的DFS无显著差异。
对于无侧方淋巴结转移的临床T3期低位直肠癌患者，术后强化化疗似乎与术前CRT预后相似。
