Benefit of the measurement of mesorectal extension in patients with pT3N1-2 rectal cancer without pre-operative chemoradiotherapy: Post-operative treatment strategy

Akagi,Yoshito; Shirouzu,Kazuo; Fujita,Shin; Ueno,Hideki; Takii,Yasumasa; Komori,Koji; Ito,Masaaki; Sugihara,Kenichi

doi:10.3892/etm.2012.858

March 2013 Volume 5 Issue 3

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March 2013 Volume 5 Issue 3

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Article

Benefit of the measurement of mesorectal extension in patients with pT3N1-2 rectal cancer without pre-operative chemoradiotherapy: Post-operative treatment strategy

Authors:
- Yoshito Akagi
- Kazuo Shirouzu
- Shin Fujita
- Hideki Ueno
- Yasumasa Takii
- Koji Komori
- Masaaki Ito
- Kenichi Sugihara
View Affiliations / Copyright

Affiliations: Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan, Colorectal Surgery Division, Department of Surgery, National Cancer Center Hospital, Tokyo, Japan, Department of Surgery, National Defense Medical College, Saitama, Japan, Division of Surgery, Niigata Cancer Center Hospital, Niigata, Japan, Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan, Colorectal and Pelvic Surgery Division, Department of Surgical Oncology, National Cancer Center Hospital East, Chiba, Japan, Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
Pages: 661-666
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Published online on: December 14, 2012

https://doi.org/10.3892/etm.2012.858
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Abstract

A treatment strategy based on the distance of mesorectal extension (DME) for pT3N1-2 rectal cancer patients without pre-operative chemoradiotherapy has not yet been defined. The present study aimed to describe the benefit of the measurement of mesorectal extension in stratifying treatment for pT3N1-2 rectal cancer patients. Data from 512 patients with pT3N1-2 rectal cancer undergoing curative surgery at 28 institutes were analyzed in this study. DME was measured histologically, and the optimal prognostic cut-off point of the DME was determined using Cox regression analyses. Survival was calculated using the Kaplan‑Meier method. The patients were subdivided into two groups based on the optimal prognostic cut-off point: DME ≤4 mm and DME >4 mm. The DME was found to be a powerful independent risk factor for predicting distant and local recurrences. The recurrence‑free 5-year survival rates of patients with DME >4 mm were significantly poorer for Stages IIIB (53.3%; p=0.0015; HR, 1.76; 95% CI, 1.233-2.501) and IIIC (32.9%; p=0.0095; HR, 1.64; 95% CI, 1.119-2.407) than for patients with DME ≤4 mm (69.7 and 50.4%, respectively). The cancer-specific survival rates of patients with DME >4 mm were also significantly worse than those with DME ≤4 mm. A value of 4 mm provides the best cut-off point for subdividing the mesorectal extension to predict oncologic outcomes. Measurement of mesorectal extension appears to be of benefit in stratifying patients for post-operative adjuvant treatments.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Benefit of the measurement of mesorectal extension in patients with pT3N1-2 rectal cancer without pre-operative chemoradiotherapy: Post-operative treatment strategy

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