Distant Metastasis Identified Immediately after Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer.
10.3393/jksc.2007.23.5.327
- Author:
In Ja PARK
1
;
Hee Cheol KIM
;
Chang Sik YU
;
Pyung Hwa CHOI
;
Sang Hoon JUNG
;
Dong Hyun HONG
;
Dae Dong KIM
;
Min Hee RYU
;
Heung Moon CHANG
;
Jong Hoon KIM
;
Jin Cheon KIM
Author Information
1. Colorectal Clinic, Department of Surgery, University of Ulsan College of Medicine, Seoul, Korea. hckim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Preoperative chemoradiotherapy;
Metastasis;
CEA
- MeSH:
Adenocarcinoma;
Chemoradiotherapy*;
Colorectal Neoplasms, Hereditary Nonpolyposis;
Drug Therapy;
Humans;
Liver;
Lung;
Lymph Nodes;
Neoplasm Metastasis*;
Radiotherapy;
Rectal Neoplasms*;
Reference Values
- From:Journal of the Korean Society of Coloproctology
2007;23(5):327-332
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was designed to analyze the clinical characteristics of patients with immediate distant metastasis after preoperative chemoradiotherapy for locally advanced rectal cancer and to help select patients for preoperative chemoradiotherapy. METHODS: Two hundred eight patients, who underwent preoperative chemoradiotherapy for locally advanced rectal cancer, were included. Patients were excluded from the study if they had tumor types other than an adenocarcinoma, prior chemotherapy, radiotherapy, or hereditary nonpolyposis colorectal cancer. The clinicopathological characteristics of patients with distant metastasis immediately after preoperative chemoradioterapy were compared with those of patients without distant metastasis. RESULTS: Distant metastases immediately after preoperative chemoradiotherapy were identified in 15 patients (7.2%). The liver was the most common site of metastasis (8/15), followed by peritoneal seeding (4), the lung (2), bone (1), and the aortocaval lymph node (1). Age, sex, chemotherapy regimen used, and primary tumor response for patients with distant metastases were similar to those for patients without distant metastasis. In patients with immediate distant metastasis, pre-chemoradiotherapy CEA was significantly higher (11.1 vs. 7.4 ng/ml; P= 0.003). CONCLUSIONS: Immediate distant metastasis after preoperative chemoradiotherapy is associated with pre-chemoradiotherapy CEA level. A careful work-up is necessary when pre-chemoradiotherapy CEA is higher than the normal range.
