Fahim Mohamed I, Shafeik Fady, Allam Rasha M, Asaad Marina, Taher Mohammad
Surgical Oncology, National Cancer Institute - Cairo University, Cairo, EGY.
Oncosurgery, National Cancer Institute, Cairo, EGY.
Cureus. 2025 Jun 1;17(6):e85171. doi: 10.7759/cureus.85171. eCollection 2025 Jun.
Aim This study aimed to evaluate the potential prognostic impact of various clinicopathological factors on survival outcomes in patients with low rectal adenocarcinoma treated with neoadjuvant chemoradiation followed by abdominoperineal resection. Methods This retrospective observational cohort study included 174 patients with low rectal adenocarcinoma who were treated and followed up between 2012 and 2019 at the National Cancer Institute - Cairo University. Results The median follow-up period was 71.2 months. The median disease-free survival (DFS) was 69 months, while the median overall survival (OS) was not reached. Multivariate analysis showed that high tumor grade was significantly associated with reduced OS (95% CI: 1.250-7.280; P = 0.014). Additionally, a circumferential resection margin (CRM) of ≤1 mm was significantly associated with reduced DFS (95% CI: 1.604-17.818; P = 0.006). Conclusions The study found no significant prognostic impact of tumor response to neoadjuvant chemoradiation. However, tumor grade and CRM status emerged as potential prognostic factors for survival in this patient population.
目的 本研究旨在评估各种临床病理因素对接受新辅助放化疗后行腹会阴联合切除术的低位直肠腺癌患者生存结局的潜在预后影响。方法 这项回顾性观察性队列研究纳入了2012年至2019年期间在开罗大学国家癌症研究所接受治疗和随访的174例低位直肠腺癌患者。结果 中位随访期为71.2个月。中位无病生存期（DFS）为69个月，而中位总生存期（OS）未达到。多因素分析显示，高肿瘤分级与OS降低显著相关（95%CI：1.250 - 7.280；P = 0.014）。此外，环周切缘（CRM）≤1 mm与DFS降低显著相关（95%CI：1.604 - 17.818；P = 0.006）。结论 该研究发现肿瘤对新辅助放化疗的反应无显著预后影响。然而，肿瘤分级和CRM状态是该患者群体生存的潜在预后因素。
