Does stage III rectal mucinous adenocarcinoma benefit from neoadjuvant chemoradiation?

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2024-10-31 DOI:10.1007/s10151-024-03027-w

L Schabl, L C Duraes, T Connelly, H Sancheti, J Miller, S R Steele, H Kessler

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引用次数: 0

Abstract

Background: This study aimed to compare clinical outcomes of patients with clinical stage III mucinous rectal adenocarcinoma (M) and non-mucinous rectal adenocarcinoma (NM) and evaluate the effectiveness of neoadjuvant chemoradiation. It was hypothesized that patients with M would fare worse with neoadjuvant chemoradiation than those with NM and that patients with M and NM not receiving chemoradiation would have similar outcomes. Moreover, it was hypothesized that patients with M would have similar outcomes regardless of chemoradiation.

Methods: This study compares eligible patients distributed in three cohorts: (cohort 1) M versus NM, including only patients treated with neoadjuvant chemoradiation; (cohort 2) M versus NM, including only patients treated without neoadjuvant chemoradiation; and (cohort 3) only M patients treated with versus without neoadjuvant chemoradiation.

Results: We identified 515 patients with an average age of 58.8 (SD 12.4) years, and 30% were female. Fifty-seven (11.1%) patients had M and 458 (88.9%) had NM. Neoadjuvant chemoradiation was administered to 382 (74%) patients, of whom 41 (10.7%) were M and 341 (89.3%) NM. In cohort 1, patients with M had advanced pathological staging (stage 3: M 68% vs. NM 42%; p < 0.001), worse pathological differentiation (poor: M, 37% vs. NM, 11%; p = 0.001), more involved lymph nodes (M 0 [0;7] vs. NM 0 [0;1]; p < 0.001) and a higher rate of local recurrence (M 22% vs. 3%; p < 0.001). Patients with M demonstrated worse 7-year cancer-specific (p = 0.007) and overall survival (p = 0.01). There were no significant differences in cohort 2 and 3.

Conclusion: Patients with clinical stage III mucinous adenocarcinomas may not benefit as much from standard neoadjuvant chemoradiation as their non-mucinous counterparts do.

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III 期直肠粘液腺癌是否受益于新辅助化疗？

研究背景本研究旨在比较临床Ⅲ期粘液性直肠腺癌（M）和非粘液性直肠腺癌（NM）患者的临床疗效，并评估新辅助化疗的效果。假设M型患者接受新辅助化疗的疗效比NM型患者差，而未接受化疗的M型和NM型患者的疗效相似。此外，研究还假设，无论是否接受化疗，M 患者的预后都相似：本研究比较了三个队列中符合条件的患者：(方法：本研究比较了三个队列中符合条件的患者：（队列 1）M 型与 NM 型患者，其中仅包括接受新辅助化疗的患者；（队列 2）M 型与 NM 型患者，其中仅包括未接受新辅助化疗的患者；以及（队列 3）仅接受新辅助化疗与未接受新辅助化疗的 M 型患者：我们共发现了 515 名患者，平均年龄为 58.8 岁（标准差为 12.4 岁），其中 30% 为女性。57例（11.1%）患者为M型，458例（88.9%）为NM型。382例（74%）患者接受了新辅助化疗，其中41例（10.7%）为男性，341例（89.3%）为女性。在队列 1 中，M 患者的病理分期较晚（3 期：M 68% 对 NM 42%；P 结论：M 患者的病理分期较晚：临床 III 期粘液腺癌患者从标准新辅助化疗中获益的程度可能不如非粘液腺癌患者。

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

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.