MRI navigation surgery, including lateral pelvic lymph node dissection following chemoradiotherapy, improves local control and functional preservation of the middle to low rectal cancer

IF 2.3 4区 医学 Q3 ONCOLOGY
Madoka Hamada , Hiroaki Kurokawa , Toshinori Kobayashi , Yoshiko Uemura
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引用次数: 0

Abstract

Purpose

The purpose of this study is to examine the appropriateness of MRI navigation surgery following chemoradiotherapy (CRT), including lateral pelvic lymph node dissection (LLND) for middle to low rectal cancer.

Methods

Forty-three consecutive patients with cT2-4b rectal cancer within 10 cm from the anal verge who underwent laparoscopic radical surgery following CRT (45–50.4Gy + S1 80mg/m2) from January 2014 and February 2020 were analyzed. We decided on the operative procedure, including LLND, based on the restaging MRI. We examined the rates of 3-year postoperative local pelvic recurrence, permanent stoma, and recurrent risk factors (Group S). We also compared the results to that of the fourteen patients who enrolled in the previous phase II trial and underwent laparoscopic radical surgery following CRT (40Gy + S-1 (80mg/m2) or UFT (300 mg/m2)) for consecutive cT2-4b rectal cancer below the peritoneal reflection. The operative procedure was decided at the initial MRI diagnosis, and the LLND was not performed (Group P).

Results

We had no local pelvic recurrence in Group S, and the three-year local pelvic recurrence-free survival was significantly better in Group S than P (100 % in S 85.1 % in P, p < 0.05). The permanent stoma rate was not different between the Groups, irrespective of the significantly high rate of cCRM(+) in Group S. The Cox proportional hazards model for significant factors of recurrence on the univariate analysis revealed that ycM and ycEMVI scores were independently significant (p < 0.001).

Conclusion

MRI navigation surgery, including LLND for rectal cancer following chemoradiotherapy, improves local control and functional preservation.

磁共振成像导航手术(包括化疗后的盆腔侧淋巴结清扫术)可提高中低位直肠癌的局部控制率和功能保留率
方法对2014年1月至2020年2月期间连续接受腹腔镜根治术的43例距肛缘10厘米以内的cT2-4b直肠癌患者进行分析,这些患者在接受CRT(45-50.4Gy + S1 80mg/m2)治疗后接受了腹腔镜根治术。我们根据 MRI 重分期结果决定手术方式,包括 LLND。我们检查了术后 3 年盆腔局部复发率、永久造口率和复发风险因素(S 组)。我们还将结果与之前参加II期试验的14名腹腔镜根治术患者的结果进行了比较,这些患者因腹膜反光以下连续性cT2-4b直肠癌接受了CRT(40Gy + S-1 (80mg/m2) 或 UFT (300 mg/m2))治疗。结果S组无局部盆腔复发,S组的三年无局部盆腔复发生存率明显优于P组(S组为100%,P组为85.1%,P< 0.05)。结论MRI导航手术,包括化放疗后直肠癌LLND,可改善局部控制和功能保留。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Surgical Oncology-Oxford
Surgical Oncology-Oxford 医学-外科
CiteScore
4.50
自引率
0.00%
发文量
169
审稿时长
38 days
期刊介绍: Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.
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