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接受新辅助放化疗及腹会阴联合切除术的低位直肠癌患者的潜在预后因素

Potential Prognostic Factors in Low Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation and Abdominoperineal Resection.

作者信息

Fahim Mohamed I, Shafeik Fady, Allam Rasha M, Asaad Marina, Taher Mohammad

机构信息

Surgical Oncology, National Cancer Institute - Cairo University, Cairo, EGY.

Oncosurgery, National Cancer Institute, Cairo, EGY.

出版信息

Cureus. 2025 Jun 1;17(6):e85171. doi: 10.7759/cureus.85171. eCollection 2025 Jun.

DOI:10.7759/cureus.85171
PMID:40458380
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12126841/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aac0/12126841/9886aad44e72/cureus-0017-00000085171-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aac0/12126841/be0637d06a26/cureus-0017-00000085171-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aac0/12126841/9886aad44e72/cureus-0017-00000085171-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aac0/12126841/be0637d06a26/cureus-0017-00000085171-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aac0/12126841/9886aad44e72/cureus-0017-00000085171-i02.jpg

相似文献

[1]
Potential Prognostic Factors in Low Rectal Cancer Patients Treated With Neoadjuvant Chemoradiation and Abdominoperineal Resection.

Cureus. 2025-6-1

[2]
Prognostic value of the circumferential resection margin and its definitions in esophageal cancer patients after neoadjuvant chemoradiotherapy.

Dis Esophagus. 2018-2-1

[3]
Laparoscopic vs open abdominoperineal resection in the multimodality management of low rectal cancers.

World J Gastroenterol. 2015-9-21

[4]
Extralevator Abdominoperineal Excision (ELAPE) is Not Superior to Abdominoperineal Excision (APE) in the Era of Neoadjuvant Treatment in Rectal Cancer.

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022-11-1

[5]
Conditional Probability of Survival After Neoadjuvant Chemoradiation and Proctectomy for Rectal Cancer: What Matters and When.

Dis Colon Rectum. 2019-1

[6]
Can induction chemotherapy before concurrent chemoradiation impact circumferential resection margin positivity and survival in low rectal cancers?

Asian Pac J Cancer Prev. 2015

[7]
Total Neoadjuvant Therapy Versus Standard Neoadjuvant Chemoradiation in Patients with Locally Advanced Rectal Cancer: A Comparison of Short- and Long-term Oncologic Outcomes.

Ann Surg. 2022-12-1

[8]
The prognostic value of tumour regression grade following neoadjuvant chemoradiation therapy for rectal cancer.

Colorectal Dis. 2014-1

[9]
Laparoscopic extralevator abdominoperineal excision in distal rectal cancer patients: a retrospective comparative study.

BMC Surg. 2022-12-8

[10]
Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: A multicentric phase II study.

Int J Radiat Oncol Biol Phys. 2006-3-15

本文引用的文献

[1]
Tissue classification and diagnosis of colorectal cancer histopathology images using deep learning algorithms. Is the time ripe for clinical practice implementation?

Prz Gastroenterol. 2023

[2]
The role of deep learning in diagnosing colorectal cancer.

Prz Gastroenterol. 2023

[3]
What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?

Yeungnam Univ J Med. 2019-5

[4]
Pathological Assessment of the AJCC Tumor Regression Grading System After Preoperative Chemoradiotherapy for Chinese Locally Advanced Rectal Cancer.

Medicine (Baltimore). 2016-1

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Partial pathologic response and nodal status as most significant prognostic factors for advanced rectal cancer treated with preoperative chemoradiotherapy.

World J Surg. 2012-3

[6]
Randomized phase III study comparing preoperative radiotherapy with chemoradiotherapy in nonresectable rectal cancer.

J Clin Oncol. 2008-8-1

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Pathologic stage is most prognostic of disease-free survival in locally advanced rectal cancer patients after preoperative chemoradiation.

Cancer. 2008-7-1

[8]
Chemotherapy with preoperative radiotherapy in rectal cancer.

N Engl J Med. 2006-9-14

[9]
Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer.

J Clin Oncol. 2005-12-1

[10]
Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer.

Br J Surg. 2002-3

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