Area of residual tumor is a robust prognostic marker for patients with rectal cancer undergoing preoperative therapy
Area of residual tumor is a robust prognostic marker for patients with rectal cancer undergoing preoperative therapy
复制标题
残余肿瘤面积是接受术前治疗的直肠癌患者的一个强有力的预后标志物
作者：
N. Sakuyama;M. Kojima;Shingo Kawano;Y. Matsuda;M. Mino‐Kenudson;A. Ochiai;Masaaki Ito
本研究的目的是阐明直肠癌患者术前放化疗和术前化疗治疗的组织学特征的差异。还评估了残留肿瘤面积（ART）作为它们之间潜在预后标志物的效用。本研究入组了68例接受保肛手术的直肠癌患者。其中，39例患者接受术前放化疗（CRT组），29例患者接受术前（新辅助）化疗（NAC组）。使用形态测量软件确定残留肿瘤的面积。比较两组肿瘤的组织学特征和临床结局的差异。CRT组和NAC组的肿瘤在术前治疗后的组织学特征方面差异很大。CRT组肿瘤纤维化程度明显高于NAC组。CRT组肿瘤的总ART明显小于NAC组。然而，在环形切除边缘阴性病理0-III期病例中，CRT组和NAC组的临床结局无统计学差异。ART和病理TNM分级与术前CRT组和NAC组的临床结局相关，但Dworak回归分级和纤维化改变与临床结局无关。接受术前CRT和NAC的患者的肿瘤在组织学特征上存在显著差异。基于残留肿瘤面积的评估可提供有用的预后信息，无论术前治疗如何。
The aim of this study was to elucidate differences in the histological features of rectal cancer between patients treated with preoperative chemoradiotherapy and those treated with preoperative chemotherapy. Area of residual tumor (ART) was also evaluated for its utility as a potential prognostic marker between them. Sixty‐eight patients with rectal cancer who underwent sphincter‐saving surgery were enrolled in this study. Of these, 39 patients received preoperative chemoradiotherapy (CRT group) and 29 patients received preoperative (neoadjuvant) chemotherapy (NAC group). Area of residual tumor was determined by using morphometric software. Tumors in the two groups were compared for differences in their histological features and clinical outcomes. Tumors in the CRT and NAC groups varied greatly with regard to their histological features after preoperative therapy. Tumors in the CRT group showed more marked fibrosis than those in the NAC group. The total ART were significantly smaller in tumors in the CRT group than those in the NAC group. However, in circumferential resection margin‐negative pathologic stage 0‐III cases, clinical outcomes were not statistically different between the CRT and NAC groups. Both ART and pathologic TNM classification were associated with clinical outcome in preoperative CRT and NAC groups, but Dworak regression grade and fibrotic change were not. Tumors in those undergoing preoperative CRT and NAC were shown to differ significantly in their histological features. Area of residual tumor‐based assessment may provide useful prognostic information, regardless of preoperative therapy.
影响因子：
8.4
作者：
Bosset, JF;Calais, G;Briffaux, A
通讯作者：
Briffaux, A