Oncologic Outcomes of Postoperative Chemoradiotherapy Versus Chemotherapy Alone in Stage II and III Upper Rectal Cancer
- Author:
Ji Eun YOON
1
;
Soo Young LEE
;
Han Duk KWAK
;
Seung Seop YEOM
;
Chang Hyun KIM
;
Jae Kyun JOO
;
Hyeong Rok KIM
;
Young Jin KIM
Author Information
- Publication Type:Original Article
- Keywords: Rectal neoplasms; Recurrence; Chemoradiotherapy; Drug therapy
- MeSH: Chemoradiotherapy; Cohort Studies; Disease-Free Survival; Drug Therapy; Follow-Up Studies; Humans; Jeollanam-do; Multivariate Analysis; Propensity Score; Radiotherapy; Rectal Neoplasms; Rectum; Recurrence; Retrospective Studies; Risk Factors; Selection Bias
- From:Annals of Coloproctology 2019;35(3):137-143
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The aim of this study was to assess oncological outcomes of postoperative radiotherapy plus chemotherapy (CRT) versus chemotherapy alone (CTx) in stage II or III upper rectal cancer patients who underwent curative surgery. METHODS: We retrospectively reviewed 263 consecutive patients with pathologic stage II or III upper rectal cancer who underwent primary curative resection with postoperative CRT or CTx from January 2008 to December 2014 at Chonnam National University Hwasun Hospital. Multivariate and propensity score matching analyses were used to reduce selection bias. RESULTS: Median follow-up was 48.1 months for the entire cohort and 53.5 months for the matched cohort. In subgroup analysis of the propensity score matched cohort, the 3-year local recurrence-free survival was 94.1% (95% confidence interval [CI], 87.8%–100%) in the CRT group and 90.1% (95% CI, 82.8%–97.9%) in the CTx group (P = 0.370). No significant difference in disease-free survival was observed according to treatment type. On multivariate analysis, circumferential resection margin involvement (hazard ratio [HR], 2.386; 95% CI, 1.190–7.599; P = 0.032), N stage (HR, 6.262; 95% CI, 1.843–21.278, P = 0.003), and T stage (HR, 5.896, 95% CI, 1.298–6.780, P = 0.021) were identified as independent risk factors for local recurrence of tumors of the upper rectum. CONCLUSION: Omission of radiotherapy in an adjuvant treatment setting may not jeopardize oncologic outcomes in stages II and III upper rectal cancer.
