Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study
Introduction: There is no standard treatment strategy for rectosigmoid cancer because of the diverse definitions of the proximal rectal origin. This study aimed to evaluate sigmoid take-off compared with other landmarks of the rectosigmoid junction in guiding oncological therapy and outcomes. Materi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958422014610 |
| _version_ | 1797669951391137792 |
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| author | Fei Li Ruize Qu Yan Meng Nan Li Ming Chen Hao Wang Xin Zhou Wei Fu |
| author_facet | Fei Li Ruize Qu Yan Meng Nan Li Ming Chen Hao Wang Xin Zhou Wei Fu |
| author_sort | Fei Li |
| collection | DOAJ |
| description | Introduction: There is no standard treatment strategy for rectosigmoid cancer because of the diverse definitions of the proximal rectal origin. This study aimed to evaluate sigmoid take-off compared with other landmarks of the rectosigmoid junction in guiding oncological therapy and outcomes. Materials and methods: This retrospective, comparative cohort study included patients diagnosed with rectosigmoid carcinoma at our centre between January 2010 and December 2018. The patients were classified into the neoadjuvant treatment group and upfront surgery group. The oncological outcomes were compared between the two groups in relation to the tumor position. Results: A total of 656 patients (median age 64 years) were included. After propensity score matching, the 3- and 5-year overall survival and disease-free survival in patients in both the groups were comparable. However, when only patients with rectal cancer as defined by the sigmoid take-off point were included, the disease-free survival rate in the upfront surgery group was significantly lower than that in the neoadjuvant treatment group (p = 0.03 in patients who underwent computed tomography, p = 0.03 in patients who underwent magnetic resonance imaging). The turning point of the beneficial hazard ratio of neoadjuvant therapy was compared according to the different definitions of the rectosigmoid junction and the sigmoid take-off was found to be the most effective. Conclusion: The sigmoid take-off point is a suitable landmark for identifying the rectosigmoid junction and is an important defining criterion for assessing the benefit of neoadjuvant therapy. The application of this definition in clinical practice and future trials is warranted. |
| first_indexed | 2024-03-11T20:52:27Z |
| format | Article |
| id | doaj.art-19f855d3989f4597ad148fdef7463059 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-03-11T20:52:27Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-19f855d3989f4597ad148fdef74630592023-10-01T05:57:31ZengElsevierAsian Journal of Surgery1015-95842023-10-01461043304336Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort studyFei Li0Ruize Qu1Yan Meng2Nan Li3Ming Chen4Hao Wang5Xin Zhou6Wei Fu7Department of General Surgery, Peking University Third Hospital, Peking University Third Hospital Cancer Center, Beijing, ChinaDepartment of General Surgery, Peking University Third Hospital, Peking University Third Hospital Cancer Center, Beijing, ChinaDepartment of General Surgery, Peking University Third Hospital, Peking University Third Hospital Cancer Center, Beijing, ChinaResearch Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, ChinaDepartment of Radiology, Peking University Third Hospital, Beijing, ChinaDepartment of Radiation Oncology, Peking University Third Hospital, Beijing, China; Corresponding author.Department of General Surgery, Peking University Third Hospital, Peking University Third Hospital Cancer Center, Beijing, China; Corresponding author.Department of General Surgery, Peking University Third Hospital, Peking University Third Hospital Cancer Center, Beijing, China; Corresponding author.Introduction: There is no standard treatment strategy for rectosigmoid cancer because of the diverse definitions of the proximal rectal origin. This study aimed to evaluate sigmoid take-off compared with other landmarks of the rectosigmoid junction in guiding oncological therapy and outcomes. Materials and methods: This retrospective, comparative cohort study included patients diagnosed with rectosigmoid carcinoma at our centre between January 2010 and December 2018. The patients were classified into the neoadjuvant treatment group and upfront surgery group. The oncological outcomes were compared between the two groups in relation to the tumor position. Results: A total of 656 patients (median age 64 years) were included. After propensity score matching, the 3- and 5-year overall survival and disease-free survival in patients in both the groups were comparable. However, when only patients with rectal cancer as defined by the sigmoid take-off point were included, the disease-free survival rate in the upfront surgery group was significantly lower than that in the neoadjuvant treatment group (p = 0.03 in patients who underwent computed tomography, p = 0.03 in patients who underwent magnetic resonance imaging). The turning point of the beneficial hazard ratio of neoadjuvant therapy was compared according to the different definitions of the rectosigmoid junction and the sigmoid take-off was found to be the most effective. Conclusion: The sigmoid take-off point is a suitable landmark for identifying the rectosigmoid junction and is an important defining criterion for assessing the benefit of neoadjuvant therapy. The application of this definition in clinical practice and future trials is warranted.http://www.sciencedirect.com/science/article/pii/S1015958422014610Rectosigmoid junctionSigmoid colonRectumNeoadjuvant chemoradiotherapy |
| spellingShingle | Fei Li Ruize Qu Yan Meng Nan Li Ming Chen Hao Wang Xin Zhou Wei Fu Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study Asian Journal of Surgery Rectosigmoid junction Sigmoid colon Rectum Neoadjuvant chemoradiotherapy |
| title | Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study |
| title_full | Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study |
| title_fullStr | Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study |
| title_full_unstemmed | Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study |
| title_short | Sigmoid take-off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation: A retrospective comparative cohort study |
| title_sort | sigmoid take off in rectosigmoid cancer as a landmark identifying benefit from neoadjuvant chemoradiation a retrospective comparative cohort study |
| topic | Rectosigmoid junction Sigmoid colon Rectum Neoadjuvant chemoradiotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S1015958422014610 |
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