Long-term outcomes in ypT0 rectal cancers: An international multi-centric investigation on behalf of Italian Society of Surgical Oncology Young Board (YSICO)

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

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Abstract

Aim To investigate the outcome and pattern of survivals of rectal cancer patients presenting a complete or nearly complete tumor response after neo-adjuvant treatment. Methods Young surgeons <40 years old affiliated to the Italian Society of Surgical Oncology (YSICO) from 13 referral centers for colorectal cancer treatment, were invited to participate a retrospective study. Records from patients treated from 2005 to 2015 with a pathological diagnosis of ypT0/ypTis were retrieved and pooled in a common data-base for statistical purposes. All clinical and pathological variables were reviewed. Univariate and multivariate analyses were conducted with the end-point of survivals. Results Two hundreds and sixty-one patients were analyzed including 237 ypT0 and 24 ypTis. Nodal positive patients were 8.7%. More than sixty-six percent of the patients did not perform adjuvant chemotherapy, with a statistical difference comparing N0 versus N+ patients (66.8% vs 40.9%, p 0.02). Mean follow-up was of 47.6 months. Twenty-two relapses were observed, 91.6% at a distant site. The mean time to recurrence was of 35.3 months. On univariate analysis, the use of adjuvant chemotherapy correlated with better OS exclusively in ypT0N + patients and not in ypT0N0. Univariate and multivariate analyses documented nodal positivity as the only prognostic factor correlated with a worse OS. Conclusion Recurrences were mostly diagnosed at a distant site and within the third year of follow-up. Nodal positivity was the only variable independently correlated with a worse OS. Univariate analysis documented a benefit for the use of adjuvant chemotherapy treatment exclusively in ypT0N + rectal cancers.
Lingua originaleEnglish
pagine (da-a)1472-1480
Numero di pagine9
RivistaEuropean Journal of Surgical Oncology
Volume43
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Italy
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neo-adjuvant treatment
  • Neoadjuvant Therapy
  • Neoplasm Grading
  • Neoplasm Staging
  • Oncology
  • Pathologic complete response
  • Rectal Neoplasms
  • Rectal cancer
  • Retrospective Studies
  • Spain
  • Surgery
  • Survival Analysis
  • Treatment Outcome
  • ypT0

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