Abstract
Purpose: Distant metastasis can occur early after neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. This study was conducted to evaluate the clinical characteristics of patients who developed early systemic failure. Methods: The patients who underwent neoadjuvant CRT for a rectal adenocarcinoma between June 2007 and July 2015 were included in this study. Patients who developed distant metastasis within 6 months after CRT were identified. We compared short- and long-term clinicopathologic outcomes of patients in the early failure (EF) group with those of patients in the control group. Results: Of 107 patients who underwent neoadjuvant CRT for rectal cancer, 7 developed early systemic failure. The lung was the most common metastatic site. In the EF group, preoperative carcinoembryonic antigen was higher (5 mg/mL vs. 2 mg/mL, P = 0.010), and capecitabine as a sensitizer of CRT was used more frequently (28.6% vs. 3%, P = 0.002). Of the 7 patients in the EF group, only 4 underwent a primary tumor resection (57.1%), in contrast to the 100% resection rate in the control group (P < 0.001). In terms of pathologic outcomes, ypN and TNM stages were more advanced in the EF group (P < 0.001 and P = 0.047, respectively), and numbers of positive and retrieved lymph nodes were much higher (P < 0.001 and P = 0.027, respectively). Conclusion: Although early distant metastasis after CRT for rectal cancer is very rare, patients who developed early metastasis showed a poor nodal response with a low primary tumor resection rate and poor oncologic outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 94-99 |
| Number of pages | 6 |
| Journal | Annals of Coloproctology |
| Volume | 35 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2019 Jan 1 |
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Keywords
- Chemoradiotherapy
- Distant metastasis
- Neoadjuvant therapy
- Rectal neoplasms
- Systemic failure
ASJC Scopus subject areas
- Gastroenterology
Cite this
Early systemic failure after preoperative chemoradiotherapy for the treatment of patients with rectal cancer. / Choi, Taesun; Baek, Se-Jin; Kwak, Jung-Myun; Kim, Jin; Kim, Seon Hahn.
In: Annals of Coloproctology, Vol. 35, No. 2, 01.01.2019, p. 94-99.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early systemic failure after preoperative chemoradiotherapy for the treatment of patients with rectal cancer
AU - Choi, Taesun
AU - Baek, Se-Jin
AU - Kwak, Jung-Myun
AU - Kim, Jin
AU - Kim, Seon Hahn
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Purpose: Distant metastasis can occur early after neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. This study was conducted to evaluate the clinical characteristics of patients who developed early systemic failure. Methods: The patients who underwent neoadjuvant CRT for a rectal adenocarcinoma between June 2007 and July 2015 were included in this study. Patients who developed distant metastasis within 6 months after CRT were identified. We compared short- and long-term clinicopathologic outcomes of patients in the early failure (EF) group with those of patients in the control group. Results: Of 107 patients who underwent neoadjuvant CRT for rectal cancer, 7 developed early systemic failure. The lung was the most common metastatic site. In the EF group, preoperative carcinoembryonic antigen was higher (5 mg/mL vs. 2 mg/mL, P = 0.010), and capecitabine as a sensitizer of CRT was used more frequently (28.6% vs. 3%, P = 0.002). Of the 7 patients in the EF group, only 4 underwent a primary tumor resection (57.1%), in contrast to the 100% resection rate in the control group (P < 0.001). In terms of pathologic outcomes, ypN and TNM stages were more advanced in the EF group (P < 0.001 and P = 0.047, respectively), and numbers of positive and retrieved lymph nodes were much higher (P < 0.001 and P = 0.027, respectively). Conclusion: Although early distant metastasis after CRT for rectal cancer is very rare, patients who developed early metastasis showed a poor nodal response with a low primary tumor resection rate and poor oncologic outcomes.
AB - Purpose: Distant metastasis can occur early after neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer. This study was conducted to evaluate the clinical characteristics of patients who developed early systemic failure. Methods: The patients who underwent neoadjuvant CRT for a rectal adenocarcinoma between June 2007 and July 2015 were included in this study. Patients who developed distant metastasis within 6 months after CRT were identified. We compared short- and long-term clinicopathologic outcomes of patients in the early failure (EF) group with those of patients in the control group. Results: Of 107 patients who underwent neoadjuvant CRT for rectal cancer, 7 developed early systemic failure. The lung was the most common metastatic site. In the EF group, preoperative carcinoembryonic antigen was higher (5 mg/mL vs. 2 mg/mL, P = 0.010), and capecitabine as a sensitizer of CRT was used more frequently (28.6% vs. 3%, P = 0.002). Of the 7 patients in the EF group, only 4 underwent a primary tumor resection (57.1%), in contrast to the 100% resection rate in the control group (P < 0.001). In terms of pathologic outcomes, ypN and TNM stages were more advanced in the EF group (P < 0.001 and P = 0.047, respectively), and numbers of positive and retrieved lymph nodes were much higher (P < 0.001 and P = 0.027, respectively). Conclusion: Although early distant metastasis after CRT for rectal cancer is very rare, patients who developed early metastasis showed a poor nodal response with a low primary tumor resection rate and poor oncologic outcomes.
KW - Chemoradiotherapy
KW - Distant metastasis
KW - Neoadjuvant therapy
KW - Rectal neoplasms
KW - Systemic failure
UR - http://www.scopus.com/inward/record.url?scp=85070228406&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070228406&partnerID=8YFLogxK
U2 - 10.3393/ac.2018.10.01
DO - 10.3393/ac.2018.10.01
M3 - Article
AN - SCOPUS:85070228406
VL - 35
SP - 94
EP - 99
JO - Annals of Coloproctology
JF - Annals of Coloproctology
SN - 2287-9714
IS - 2
ER -