Clinical implication of negative conversion of predicted circumferential resection margin status after preoperative chemoradiotherapy for locally advanced rectal cancer

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Abstract

Objective To evaluate the prognostic implication of the negative conversion of predicted circumferential resection margin status before surgery in patients with locally advanced rectal cancer with predicted circumferential resection margin involvement. Methods Thirty-eight patients (28 men, 10 women; median age, 61 years; age range, 39-80 years) with locally advanced rectal cancer with predicted circumferential resection margin involvement who underwent preoperative chemoradiotherapy followed by radical surgery were analyzed. Involvement of the circumferential resection margin was predicted on the basis of pre- and post-chemoradiotherapy magnetic resonance imaging. The primary endpoints were 3-year local recurrence-free survival and overall survival. Results The median follow-up time was 41.1 months (range, 13.9-85.2 months). The negative conversion rate of predicted circumferential resection margin status after preoperative chemoradiotherapy was 65.8%. Patients who experienced negative conversion of predicted circumferential resection margin status had a significantly higher 3-year local recurrence-free survival rate (100.0% vs. 76.9%; P = 0.013), disease-free survival rate (91.7% vs. 59.3%; P = 0.023), and overall survival rate (96.0% vs. 73.8%; P = 0.016) than those who had persistent circumferential resection margin involvement. Conclusions The negative conversion of the predicted circumferential resection margin status as predicted by magnetic resonance imaging will assist in individual risk stratification as a predictive factor for treatment response and survival before surgery. These findings may help physicians determine whether to administer more intense adjuvant chemotherapy or change the surgical plan for patients displaying resistance to preoperative chemoradiotherapy.

Original languageEnglish
Pages (from-to)245-249
Number of pages5
JournalEuropean Journal of Radiology
Volume83
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

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Chemoradiotherapy
Rectal Neoplasms
Survival Rate
Survival
Magnetic Resonance Imaging
Recurrence
Margins of Excision
Adjuvant Chemotherapy
Disease-Free Survival
Physicians

Keywords

  • Circumferential resection margin
  • Magnetic resonance imaging
  • Preoperative chemoradiotherapy
  • Rectal neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{fbd0ce1eba794261b68d67e80a4e862b,
title = "Clinical implication of negative conversion of predicted circumferential resection margin status after preoperative chemoradiotherapy for locally advanced rectal cancer",
abstract = "Objective To evaluate the prognostic implication of the negative conversion of predicted circumferential resection margin status before surgery in patients with locally advanced rectal cancer with predicted circumferential resection margin involvement. Methods Thirty-eight patients (28 men, 10 women; median age, 61 years; age range, 39-80 years) with locally advanced rectal cancer with predicted circumferential resection margin involvement who underwent preoperative chemoradiotherapy followed by radical surgery were analyzed. Involvement of the circumferential resection margin was predicted on the basis of pre- and post-chemoradiotherapy magnetic resonance imaging. The primary endpoints were 3-year local recurrence-free survival and overall survival. Results The median follow-up time was 41.1 months (range, 13.9-85.2 months). The negative conversion rate of predicted circumferential resection margin status after preoperative chemoradiotherapy was 65.8{\%}. Patients who experienced negative conversion of predicted circumferential resection margin status had a significantly higher 3-year local recurrence-free survival rate (100.0{\%} vs. 76.9{\%}; P = 0.013), disease-free survival rate (91.7{\%} vs. 59.3{\%}; P = 0.023), and overall survival rate (96.0{\%} vs. 73.8{\%}; P = 0.016) than those who had persistent circumferential resection margin involvement. Conclusions The negative conversion of the predicted circumferential resection margin status as predicted by magnetic resonance imaging will assist in individual risk stratification as a predictive factor for treatment response and survival before surgery. These findings may help physicians determine whether to administer more intense adjuvant chemotherapy or change the surgical plan for patients displaying resistance to preoperative chemoradiotherapy.",
keywords = "Circumferential resection margin, Magnetic resonance imaging, Preoperative chemoradiotherapy, Rectal neoplasms",
author = "Lee, {Nam Kwon} and Kim, {Chul Yong} and Park, {Young Je} and Dae-Sik Yang and Yoon, {Won Sup} and Kim, {Seon Hahn} and Jin Kim",
year = "2014",
month = "2",
day = "1",
doi = "10.1016/j.ejrad.2013.10.029",
language = "English",
volume = "83",
pages = "245--249",
journal = "European Journal of Radiology",
issn = "0720-048X",
publisher = "Elsevier Ireland Ltd",
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T1 - Clinical implication of negative conversion of predicted circumferential resection margin status after preoperative chemoradiotherapy for locally advanced rectal cancer

AU - Lee, Nam Kwon

AU - Kim, Chul Yong

AU - Park, Young Je

AU - Yang, Dae-Sik

AU - Yoon, Won Sup

AU - Kim, Seon Hahn

AU - Kim, Jin

PY - 2014/2/1

Y1 - 2014/2/1

N2 - Objective To evaluate the prognostic implication of the negative conversion of predicted circumferential resection margin status before surgery in patients with locally advanced rectal cancer with predicted circumferential resection margin involvement. Methods Thirty-eight patients (28 men, 10 women; median age, 61 years; age range, 39-80 years) with locally advanced rectal cancer with predicted circumferential resection margin involvement who underwent preoperative chemoradiotherapy followed by radical surgery were analyzed. Involvement of the circumferential resection margin was predicted on the basis of pre- and post-chemoradiotherapy magnetic resonance imaging. The primary endpoints were 3-year local recurrence-free survival and overall survival. Results The median follow-up time was 41.1 months (range, 13.9-85.2 months). The negative conversion rate of predicted circumferential resection margin status after preoperative chemoradiotherapy was 65.8%. Patients who experienced negative conversion of predicted circumferential resection margin status had a significantly higher 3-year local recurrence-free survival rate (100.0% vs. 76.9%; P = 0.013), disease-free survival rate (91.7% vs. 59.3%; P = 0.023), and overall survival rate (96.0% vs. 73.8%; P = 0.016) than those who had persistent circumferential resection margin involvement. Conclusions The negative conversion of the predicted circumferential resection margin status as predicted by magnetic resonance imaging will assist in individual risk stratification as a predictive factor for treatment response and survival before surgery. These findings may help physicians determine whether to administer more intense adjuvant chemotherapy or change the surgical plan for patients displaying resistance to preoperative chemoradiotherapy.

AB - Objective To evaluate the prognostic implication of the negative conversion of predicted circumferential resection margin status before surgery in patients with locally advanced rectal cancer with predicted circumferential resection margin involvement. Methods Thirty-eight patients (28 men, 10 women; median age, 61 years; age range, 39-80 years) with locally advanced rectal cancer with predicted circumferential resection margin involvement who underwent preoperative chemoradiotherapy followed by radical surgery were analyzed. Involvement of the circumferential resection margin was predicted on the basis of pre- and post-chemoradiotherapy magnetic resonance imaging. The primary endpoints were 3-year local recurrence-free survival and overall survival. Results The median follow-up time was 41.1 months (range, 13.9-85.2 months). The negative conversion rate of predicted circumferential resection margin status after preoperative chemoradiotherapy was 65.8%. Patients who experienced negative conversion of predicted circumferential resection margin status had a significantly higher 3-year local recurrence-free survival rate (100.0% vs. 76.9%; P = 0.013), disease-free survival rate (91.7% vs. 59.3%; P = 0.023), and overall survival rate (96.0% vs. 73.8%; P = 0.016) than those who had persistent circumferential resection margin involvement. Conclusions The negative conversion of the predicted circumferential resection margin status as predicted by magnetic resonance imaging will assist in individual risk stratification as a predictive factor for treatment response and survival before surgery. These findings may help physicians determine whether to administer more intense adjuvant chemotherapy or change the surgical plan for patients displaying resistance to preoperative chemoradiotherapy.

KW - Circumferential resection margin

KW - Magnetic resonance imaging

KW - Preoperative chemoradiotherapy

KW - Rectal neoplasms

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