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International Journal of Colorectal Disease

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01-09-2017 | Original Article

Survival analysis in rectal carcinoma after neoadjuvant chemoradiation: various methods with different results

Authors: Susanne Merkel, Klaus Weber, Jonas Göhl, Abbas Agaimy, Rainer Fietkau, Werner Hohenberger, Robert Grützmann, Paul Hermanek

Published in: International Journal of Colorectal Disease | Issue 9/2017

Abstract

Purpose

Survival is an important indicator of outcome quality in rectal carcinoma. The 5-year survival rate is the typical outcome measurement. In patients with neoadjuvant chemoradiation followed by curative surgery, 7 years of follow-up is recommended. Different methods of survival analysis lead to different results. Here, we compared four different methods.

Methods

The data of 439 patients with rectal carcinoma treated with neoadjuvant chemoradiation followed by curative total mesorectal excision (TME) surgery between 1995 and 2010 were analysed. After stratifying by stage, relative survival (RS), cancer-related survival (CRS), overall survival (OS) and disease-free survival (DFS) were compared. In particular, the 3-year disease-free survival rate was compared to the 5- and 7-year overall survival rates.

Results

In the total cohort, the 5-year survival rates ranged from 90% (RS), over 84% (CRS) and 83% (OS) to 72% (DFS). Depending on the stage of disease, the differences between the 5-year survival rates varied between 10 and 32 percentage points. The differences were lowest in UICC stage y0 and highest in UICC stage yIV. The 3-year DFS-rate was always lower (worse) than the 5-year OS rate and higher (better) than the 7-year OS rate, with the exception of stage yIV.

Conclusions

Comparisons of survival are only meaningful if the same methods are applied. The 3-year rate of DFS was always worse than the rate of 5-year OS. Therefore, the 3-year rate of DFS appears to be a useful surrogate indicator in rectal carcinoma treatment studies.

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Title: Survival analysis in rectal carcinoma after neoadjuvant chemoradiation: various methods with different results
Authors: Susanne Merkel
Klaus Weber
Jonas Göhl
Abbas Agaimy
Rainer Fietkau
Werner Hohenberger
Robert Grützmann
Paul Hermanek
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 9/2017
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-017-2861-1

At a glance: The STEP trials

Springer Medicine

Survival analysis in rectal carcinoma after neoadjuvant chemoradiation: various methods with different results

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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