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01-12-2012 | Original Research

Impact of solitary single glandular appearance on tumor recurrence in patients with rectal cancer after preoperative chemoradiotherapy

Authors: Susumu Saigusa, Yasuhiro Inoue, Koji Tanaka, Yuji Toiyama, Kohei Matsushita, Mikio Kawamura, Yoshinaga Okugawa, Junichiro Hiro, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki

Published in: Journal of Radiation Oncology | Issue 4/2012

Abstract

Background

Tumor regression grading (TRG) reportedly has a prognostic value in rectal cancer patients who have undergone preoperative chemoradiotherapy (CRT). However, TRG is difficult to evaluate objectively. The aim of this study was to identify pathological features associated with clinical outcome, compared with conventional TRG, following preoperative CRT.

Methods

A total of 67 patients with locally advanced rectal cancer underwent preoperative CRT and curative surgery. The association of two pathological features, solitary single glandular appearance (SSGA) and superficial viable cancer cells (SVCC), with clinicopathological variables was investigated, and the clinical significance of these features was compared to conventional TRG. Moreover, transcriptional analyses were performed on residual cancer cells associated with these pathological features.

Results

Of the 67 patients, 34.3 and 74.6 % had detectable SSGA and SVCC, respectively. Patients with tumor recurrence had a significantly higher frequency of SSGA (P < 0.001). There were significant correlations among each TRG, SSGA, and SVCC. Postoperative stage, lymph node metastasis, JSCCR TRG, Rödel TRG, and SSGA were significantly associated with a poor probability of recurrence-free survival. Multivariate analysis indicated that the presence of SSGA is an independent prognostic factor for tumor recurrence (P = 0.0033). In transcriptional analysis, residual cancer with SSGA had significantly higher levels of LGR5 and GLUT1 gene expression than those without SSGA.

Conclusion

SSGA may be a useful predictor of tumor recurrence for patients with locally advanced rectal cancer treated with preoperative CRT.

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Title: Impact of solitary single glandular appearance on tumor recurrence in patients with rectal cancer after preoperative chemoradiotherapy
Authors: Susumu Saigusa
Yasuhiro Inoue
Koji Tanaka
Yuji Toiyama
Kohei Matsushita
Mikio Kawamura
Yoshinaga Okugawa
Junichiro Hiro
Keiichi Uchida
Yasuhiko Mohri
Masato Kusunoki
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Journal of Radiation Oncology / Issue 4/2012
Print ISSN: 1948-7894
Electronic ISSN: 1948-7908
DOI: https://doi.org/10.1007/s13566-012-0018-y

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Abstract

Background

Methods

Results

Conclusion

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