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Jae Kyun Joo 2 Articles
Oncologic Outcomes of Postoperative Chemoradiotherapy Versus Chemotherapy Alone in Stage II and III Upper Rectal Cancer
Ji Eun Yoon, Soo Young Lee, Han Duk Kwak, Seung Seop Yeom, Chang Hyun Kim, Jae Kyun Joo, Hyeong Rok Kim, Young Jin Kim
Ann Coloproctol. 2019;35(3):137-143.   Published online June 30, 2019
DOI: https://doi.org/10.3393/ac.2018.09.28
  • 3,992 View
  • 106 Download
  • 4 Web of Science
  • 4 Citations
AbstractAbstract PDF
Purpose
The aim of this study was to assess oncological outcomes of postoperative radiotherapy plus chemotherapy (CRT) versus chemotherapy alone (CTx) in stage II or III upper rectal cancer patients who underwent curative surgery.
Methods
We retrospectively reviewed 263 consecutive patients with pathologic stage II or III upper rectal cancer who underwent primary curative resection with postoperative CRT or CTx from January 2008 to December 2014 at Chonnam National University Hwasun Hospital. Multivariate and propensity score matching analyses were used to reduce selection bias.
Results
Median follow-up was 48.1 months for the entire cohort and 53.5 months for the matched cohort. In subgroup analysis of the propensity score matched cohort, the 3-year local recurrence-free survival was 94.1% (95% confidence interval [CI], 87.8%–100%) in the CRT group and 90.1% (95% CI, 82.8%–97.9%) in the CTx group (P = 0.370). No significant difference in disease-free survival was observed according to treatment type. On multivariate analysis, circumferential resection margin involvement (hazard ratio [HR], 2.386; 95% CI, 1.190–7.599; P = 0.032), N stage (HR, 6.262; 95% CI, 1.843–21.278, P = 0.003), and T stage (HR, 5.896, 95% CI, 1.298–6.780, P = 0.021) were identified as independent risk factors for local recurrence of tumors of the upper rectum.
Conclusion
Omission of radiotherapy in an adjuvant treatment setting may not jeopardize oncologic outcomes in stages II and III upper rectal cancer.

Citations

Citations to this article as recorded by  
  • Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients
    Zhiwei Ma, Jumei Zhou, Ke Liu, Sisi Chen, Qinghui Wu, Lin Peng, Wei Zhao, Suyu Zhu
    Radiation Oncology.2024;[Epub]     CrossRef
  • The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement
    Sean J. Langenfeld, Bradley R. Davis, Jon D. Vogel, Jennifer S. Davids, Larissa K.F. Temple, Kyle G. Cologne, Samantha Hendren, Steven Hunt, Julio Garcia Aguilar, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
    Diseases of the Colon & Rectum.2023;[Epub]     CrossRef
  • Which Definition of Upper Rectal Cancer Is Optimal in Selecting Stage II or III Rectal Cancer Patients to Avoid Postoperative Adjuvant Radiation?
    Xian Hua Gao, Bai Zhi Zhai, Juan Li, Jean Luc Tshibangu Kabemba, Hai Feng Gong, Chen Guang Bai, Ming Lu Liu, Shao Ting Zhang, Fu Shen, Lian Jie Liu, Wei Zhang
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis
    Xin-qi Shi, Jing-yu Zhang, Hua Tian, Ling-na Tang, Ai-lin Li
    Journal of Zhejiang University-SCIENCE B.2020; 21(7): 549.     CrossRef
Clinical Significance of Tumor Regression Grade in Rectal Cancer with Preoperative Chemoradiotherapy
Young Joo Park, Byung Ryul Oh, Sang Woo Lim, Jung Wook Huh, Jae Kyun Joo, Young Jin Kim, Hyeong Rok Kim
J Korean Soc Coloproctol. 2010;26(4):279-286.   Published online August 31, 2010
DOI: https://doi.org/10.3393/jksc.2010.26.4.279
  • 4,357 View
  • 32 Download
  • 18 Citations
AbstractAbstract PDF
Purpose

Neoadjuvant chemoradiotherapy applied to the locally advanced rectal cancer reduces local recurrence and improves survival. We assessed tumor regression grade (TRG) and its influence on survival in rectal cancer patients treated with chemoradiotherapy followed by surgical resection.

Methods

We studied 108 patients that were seen at our hospital between August 2004 and December 2008. Patients received preoperative chemoradiotherapy consisting of 5-fluorouracil and leucovorin by continous infusion during the first and fifth week, delivered with concurrent pelvic radiation of 50.4 Gy, followed by radical surgery at 6-8 weeks. The TRG was determined by the amount of fibrosis in the tumor embedding area and was divided into 5 grades based on the relative amount of fibrosis. We analyzed all preoperative clinicopathologic factors, postoperative pathologic stages, TRG and prognosis, retrospectively.

Results

Downstaging of rectal cancer through neoadjuvant chemoradiotherapy occurred in 64 (59%) patients. The numbers of total regressions (TRG4), good regressions (TRG3), moderate regressions (TRG2), minor regressions (TRG1), and no regression (TRG0) were 19 (18%), 65 (60%), 17 (16%), 6 (5%), and 1 (1%) respectively. The TRG was inversely correlated with perineural invasion and lymphovascular invasion (P = 0.008, P = 0.032). The local recurrence rate declined as the tumor regression grade increased (P = 0.032). The 19 patients with TRG4 had a better three-year disease free survival than the 89 patients with TRG0-3 (P = 0.034). The 16 patients with pathologic complete remission (pCR) had a better three-year disease free survival than the 92 patients with non-pCR (P = 0.025).

Conclusion

Higher TRG after preoperative chemoradiotherapy for rectal cancer closely correlates with better survival and low local recurrence. The TRG is considered to be a significant prognostic factor.

Citations

Citations to this article as recorded by  
  • An investigation into tumor regression grade as a parameter for locally advanced rectal cancer and 5-year overall survival rate
    Supparerk Laohawiriyakamol, Wongsakorn Chaochankit, Worawit Wanichsuwan, Kanet Kanjanapradit, Teeranan Laohawiriyakamol
    Annals of Coloproctology.2023; 39(1): 59.     CrossRef
  • Rezultate preliminare ale markerilor ca predictori ai răspunsului tisular la radiochimioterapie în cancerul rectal
    Sânziana Ionescu, Petre Radu, Octavia Luciana Madge, Victor Strâmbu
    Oncolog-Hematolog.ro.2022; 1(58): 8.     CrossRef
  • Clinical Implication of Perineural and Lymphovascular Invasion in Rectal Cancer Patients Who Underwent Surgery After Preoperative Chemoradiotherapy
    Young Il Kim, Chan Wook Kim, Jong Hoon Kim, Jihun Kim, Jun-Soo Ro, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
    Diseases of the Colon & Rectum.2022; 65(11): 1325.     CrossRef
  • Downstaging in Advanced Rectal Cancers: A Propensity-Matched Comparison Between Short-Course Radiotherapy Followed by Chemotherapy and Long-Course Chemoradiotherapy
    Praveen S. Kammar, Niharika R. Garach, Sivasanker Masillamany, Ashwin de’Souza, Vikas Ostwal, Avanish P. Saklani
    Diseases of the Colon & Rectum.2022; 65(10): 1215.     CrossRef
  • Overexpression of MLPH in Rectal Cancer Patients Correlates with a Poorer Response to Preoperative Chemoradiotherapy and Reduced Patient Survival
    Wan-Shan Li, Chih-I Chen, Hsin-Pao Chen, Kuang-Wen Liu, Chia-Jen Tsai, Ching-Chieh Yang
    Diagnostics.2021; 11(11): 2132.     CrossRef
  • How to measure tumour response in rectal cancer? An explanation of discrepancies and suggestions for improvement
    Iris D. Nagtegaal, Rob Glynne-Jones
    Cancer Treatment Reviews.2020; 84: 101964.     CrossRef
  • Neoadjuvant chemoradiotherapy might provide survival benefit in patients with stage IIIb/IIIc locally advanced rectal cancer: A retrospective single‐institution study with propensity score‐matched comparative analysis
    Xi‐yu Sun, Song‐hua Cai, Lai Xu, Dan Luo, Hui‐zhong Qiu, Bin Wu, Guo‐le Lin, Jun‐yang Lu, Guan‐nan Zhang, Yi Xiao
    Asia-Pacific Journal of Clinical Oncology.2020; 16(3): 142.     CrossRef
  • Prognostic value of tumour regression grade in locally advanced rectal cancer: a systematic review and meta‐analysis
    J. C. Kong, G. R. Guerra, S. K. Warrier, A. Craig Lynch, M. Michael, S. Y. Ngan, W. Phillips, G. Ramsay, A. G. Heriot
    Colorectal Disease.2018; 20(7): 574.     CrossRef
  • UEG Week 2018 Poster Presentations

    United European Gastroenterology Journal.2018;[Epub]     CrossRef
  • Prognostic significance of tumour regression grade after neoadjuvant chemoradiotherapy for a cohort of patients with locally advanced rectal cancer: an 8‐year retrospective single‐institutional study
    L. Xu, S. Cai, T. Xiao, Y. Chen, H. Qiu, B. Wu, G. Lin, X. Sun, J. Lu, W. Zhou, Y. Xiao
    Colorectal Disease.2017;[Epub]     CrossRef
  • Magnetic resonance tumor regression grade (MR-TRG) to assess pathological complete response following neoadjuvant radiochemotherapy in locally advanced rectal cancer
    Marco Rengo, Simona Picchia, Simona Marzi, Davide Bellini, Damiano Caruso, Mauro Caterino, Maria Ciolina, Domenico De Santis, Daniela Musio, Vincenzo Tombolini, Andrea Laghi
    Oncotarget.2017; 8(70): 114746.     CrossRef
  • Oncologic impact of pathologic response on clinical outcome after preoperative chemoradiotherapy in locally advanced rectal cancer
    Wook Hyeon Yoon, Hun Jin Kim, Chang Hyun Kim, Jae Kyoon Joo, Young Jin Kim, Hyeong Rok Kim
    Annals of Surgical Treatment and Research.2015; 88(1): 15.     CrossRef
  • Low Lymph Node Retrieval After Preoperative Chemoradiation for Rectal Cancer is Associated with Improved Prognosis in Patients with a Good Tumor Response
    Hun Jin Kim, Jeong Seon Jo, Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
    Annals of Surgical Oncology.2015; 22(6): 2075.     CrossRef
  • Clinical Prediction of Pathological Complete Response After Preoperative Chemoradiotherapy for Rectal Cancer
    Jung Wook Huh, Hyeong Rok Kim, Young Jin Kim
    Diseases of the Colon & Rectum.2013; 56(6): 698.     CrossRef
  • Prognostic Significance of Partial Tumor Regression After Preoperative Chemoradiotherapy for Rectal Cancer
    Yen-Chien Lee, Chung-Cheng Hsieh, Jen-Pin Chuang
    Diseases of the Colon & Rectum.2013; 56(9): 1093.     CrossRef
  • Prognostic Role of p53 Messenger Ribonucleic Acid Expression in Patients after Curative Resection for Stage I to III Colorectal Cancer: Association with Colon Cancer Stem Cell Markers
    Jung Wook Huh, Hyeong Rok Kim, Young Jin Kim
    Journal of the American College of Surgeons.2013; 216(6): 1063.     CrossRef
  • A phase II study of neoadjuvant chemoradiotherapy with oxaliplatin and capecitabine for rectal cancer
    Lin Zhao, Chunmei Bai, Yajuan Shao, Mei Guan, Ning Jia, Yi Xiao, Huizhong Qiu, Fuquan Zhang, Ti Yang, Guangxi Zhong, Shuchang Chen
    Cancer Letters.2011; 310(2): 134.     CrossRef
  • Oncologic outcomes of pathologic stage I lower rectal cancer with or without preoperative chemoradiotherapy: Are they comparable?
    Jung Wook Huh, Chang Hyun Kim, Hyeong Rok Kim, Young Jin Kim
    Surgery.2011; 150(5): 980.     CrossRef

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