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International Journal of Colorectal Disease

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01-02-2014 | Original Article

Factors associated with lateral pelvic recurrence after curative resection following neoadjuvant chemoradiotherapy in rectal cancer patients

Authors: Tae Gyu Kim, Won Park, Doo Ho Choi, Hee Chul Park, Seok-Hyung Kim, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Jeeyun Lee, Joon Oh Park, Young Suk Park, Ho Yeong Lim, Won Ki Kang, Ho-Kyung Chun

Published in: International Journal of Colorectal Disease | Issue 2/2014

Abstract

Purpose

This study aims to determine the risk factors for lateral pelvic recurrence (LPR) in rectal cancer patients treated with neoadjuvant chemoradiotherapy (CRT) and curative surgery.

Methods

Four hundred forty-three patients treated with neoadjuvant CRT and curative surgery from October 1999 through June 2009 were analyzed. All patients underwent total mesorectal resection without lateral pelvic lymph node (LPLN) dissection. Recurrence patterns and lateral pelvic recurrence-free survival (LPFS) were evaluated relative to clinicopathologic parameters including pelvic LN status.

Results

Median follow-up was 52 months, with locoregional recurrence in 53 patients (11.9 %). Of the 53 patients, 28 (52.8 %) developed LPR, of which eight had both central and lateral PR. Multivariate analysis showed a significant relationship between LPFS and the number of lateral pelvic LN (p = 0.010) as well as the ratio of the number of positive LN/number of dissected LN (p = 0.038). The relationship between LPFS and LPLN size had a marginal trend (p = 0.085). Logistic regression analysis showed positive relationships between LPR probability and the number of LPLN (odds ratio [OR] 1.507; 95 % confidence interval [CI] 1.177–1.929; p = 0.001) as well as LPLN size (OR 1.124; CI 1.029–1.227, p = 0.009).

Conclusions

LPLN ≥ 2 and a ratio of the number of positive LN/number of dissected LN > 0.3 were prognostic of poor LPFS. The prediction curve of LPR according to the number and size of LPLN could be useful for determining the benefit of additional lateral pelvic treatment.

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Title: Factors associated with lateral pelvic recurrence after curative resection following neoadjuvant chemoradiotherapy in rectal cancer patients
Authors: Tae Gyu Kim
Won Park
Doo Ho Choi
Hee Chul Park
Seok-Hyung Kim
Yong Beom Cho
Seong Hyeon Yun
Hee Cheol Kim
Woo Yong Lee
Jeeyun Lee
Joon Oh Park
Young Suk Park
Ho Yeong Lim
Won Ki Kang
Ho-Kyung Chun
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-013-1797-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Factors associated with lateral pelvic recurrence after curative resection following neoadjuvant chemoradiotherapy in rectal cancer patients

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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