Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients
Abstract Background To investigate the impact of radiotherapy (RT) on recurrence and survival in patients with locally advanced upper rectal cancer underwent curative resection. Methods 363 locally advanced upper rectal cancer cases were identified from the database of our hospital from 2010 to 2018...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-024-02403-y |
| _version_ | 1797349800362901504 |
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| author | Zhiwei Ma Jumei Zhou Ke Liu Sisi Chen Qinghui Wu Lin Peng Wei Zhao Suyu Zhu |
| author_facet | Zhiwei Ma Jumei Zhou Ke Liu Sisi Chen Qinghui Wu Lin Peng Wei Zhao Suyu Zhu |
| author_sort | Zhiwei Ma |
| collection | DOAJ |
| description | Abstract Background To investigate the impact of radiotherapy (RT) on recurrence and survival in patients with locally advanced upper rectal cancer underwent curative resection. Methods 363 locally advanced upper rectal cancer cases were identified from the database of our hospital from 2010 to 2018. All patients underwent curative resection and had the lower margin of the tumor located 10–15 cm from the anal verge, among them, 69 patients received pre- or post-operative radiotherapy and 294 patients without. Local control and survivals were compared, and stratification grouping based on European Society for Medical Oncology risk factors were further compared. 1:2 propensity score matching analysis was used to reduce the impact of confounding factors. Results There were 207 patients after 1:2 matching (RT group:non-RT group = 69:138). The 5-year overall survival (OS) of the RT group and non-RT group after matching was 84.1% and 80.9%, respectively(P = 0.440); the 5-year local recurrence-free survival (LRFS) was 96.5% and 94.7%, respectively(P = 0.364); the 5-year distant metastasis-free survival (DMFS) was 76.8% and 76.9%, respectively(P = 0.531). Subgroup analysis showed that radiotherapy could not significantly improve the overall survival, local recurrence, and distant metastasis with or without poor prognostic features. In the high-risk subgroup, the 5-year OS was 76.9% and 79.6% for patients treated with radiotherapy and without (P = 0.798), LRFS was 94.8% and 94.2%, respectively (P = 0.605), DMFS 68.7% and 74.7%, respectively (P = 0.233). Conclusions Our results suggest that radiotherapy could not improve local control and survival for locally advanced upper rectal cancer patients underwent curative resection, even in the cases with poor prognostic features. |
| first_indexed | 2024-03-08T12:35:40Z |
| format | Article |
| id | doaj.art-af5e2c1c24984e2ba0e5a9e7d5ba8a6f |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-03-08T12:35:40Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-af5e2c1c24984e2ba0e5a9e7d5ba8a6f2024-01-21T12:29:12ZengBMCRadiation Oncology1748-717X2024-01-0119111110.1186/s13014-024-02403-yIs radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patientsZhiwei Ma0Jumei Zhou1Ke Liu2Sisi Chen3Qinghui Wu4Lin Peng5Wei Zhao6Suyu Zhu7Department of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityDepartment of Radiation Oncology, Hunan Cancer Hospital / The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South UniversityAbstract Background To investigate the impact of radiotherapy (RT) on recurrence and survival in patients with locally advanced upper rectal cancer underwent curative resection. Methods 363 locally advanced upper rectal cancer cases were identified from the database of our hospital from 2010 to 2018. All patients underwent curative resection and had the lower margin of the tumor located 10–15 cm from the anal verge, among them, 69 patients received pre- or post-operative radiotherapy and 294 patients without. Local control and survivals were compared, and stratification grouping based on European Society for Medical Oncology risk factors were further compared. 1:2 propensity score matching analysis was used to reduce the impact of confounding factors. Results There were 207 patients after 1:2 matching (RT group:non-RT group = 69:138). The 5-year overall survival (OS) of the RT group and non-RT group after matching was 84.1% and 80.9%, respectively(P = 0.440); the 5-year local recurrence-free survival (LRFS) was 96.5% and 94.7%, respectively(P = 0.364); the 5-year distant metastasis-free survival (DMFS) was 76.8% and 76.9%, respectively(P = 0.531). Subgroup analysis showed that radiotherapy could not significantly improve the overall survival, local recurrence, and distant metastasis with or without poor prognostic features. In the high-risk subgroup, the 5-year OS was 76.9% and 79.6% for patients treated with radiotherapy and without (P = 0.798), LRFS was 94.8% and 94.2%, respectively (P = 0.605), DMFS 68.7% and 74.7%, respectively (P = 0.233). Conclusions Our results suggest that radiotherapy could not improve local control and survival for locally advanced upper rectal cancer patients underwent curative resection, even in the cases with poor prognostic features.https://doi.org/10.1186/s13014-024-02403-yLocally advanced rectal cancerUpper rectal cancerRisk factorsRadiotherapyPrognosis analysis |
| spellingShingle | Zhiwei Ma Jumei Zhou Ke Liu Sisi Chen Qinghui Wu Lin Peng Wei Zhao Suyu Zhu Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients Radiation Oncology Locally advanced rectal cancer Upper rectal cancer Risk factors Radiotherapy Prognosis analysis |
| title | Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients |
| title_full | Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients |
| title_fullStr | Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients |
| title_full_unstemmed | Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients |
| title_short | Is radiotherapy necessary for upper rectal cancer underwent curative resection? A retrospective study of 363 patients |
| title_sort | is radiotherapy necessary for upper rectal cancer underwent curative resection a retrospective study of 363 patients |
| topic | Locally advanced rectal cancer Upper rectal cancer Risk factors Radiotherapy Prognosis analysis |
| url | https://doi.org/10.1186/s13014-024-02403-y |
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