NDLI: Association between histological type of tumour growth and patient survival in t2-t3 lymph node-negative rectal cancer treated with sphincter-preserving total mesorectal excision.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Szynglarewicz, Bartlomiej Matkowski, Rafal Halon, Agnieszka Lacko, Aleksandra Stepien, Marcin Forgacz, Jozef Pudelko, Marek Kornafel, Jan
Description	Country affiliation: Poland Author Affiliation: Szynglarewicz B ( 2nd Department of Surgical Oncology, Lower Silesian Oncology Center, Wroclaw, Poland.)
Abstract	For rectal cancer patients without nodal metastases the identification of unfavourable factors can be helpful for the better selection for adjuvant therapy and multimodality treatment. The aim of this study was to evaluate the impact of clinico-histological parameters on prognosis in node-negative rectal cancer patients. One hundred and thirty-nine consecutive node negative rectal cancer patients with complete five-year follow-up were studied prospectively. All of them underwent curative anterior resection with total mesorectal excision technique. Seventy-eight patients with tumour penetration beyond the bowel wall received neo-adjuvant short-course radiation (25 Gy) followed by surgery within 1 week and postoperative chemotherapy with 5-fluorouracil and folinic acid in six cycles or adjuvant radiochemotherapy: irradiation (50.4 Gy) combined with chemotherapy (as above). Cancer-specific survival was calculated according to the Kaplan-Meier method. Variables significant in univariate analysis by log-rank test (P < 0.05) entered the Cox proportional hazard model. Survival was decreased for males, older patients (>60 years) with extraperitoneal, poorly differentiated cancers, tumours with mucinous histology and with the absence of lymphocytic infiltration but with the lack of statistical importance. Prognosis was significantly improved for patients with T2 tumours versus T3 (P < 0.01) and with cancers with expanding growth comparing to diffusely infiltrating ones (P < 0.01). In multivariate analysis these parameters significantly and independently influenced survival (P < 0.01 and P < 0.05, respectively). Diffusely infiltrating growth of tumour can reflect the more aggressive cancer behaviour and unfavourable course of disease despite the optimised local control. Apart from the extent of tumour penetration the type of invasive margin can be an additional parameter helpful for the optimal treatment planning and better patient selection for postoperative chemotherapy.
File Format	HTM / HTML
ISSN	12194956
Issue Number	2
Volume Number	16
e-ISSN	15322807
Journal	Pathology & Oncology Research
Language	English
Publisher	Springer
Publisher Date	2010-06-01
Publisher Place	Netherlands
Access Restriction	Subscribed
Subject Keyword	Discipline Oncology Adenocarcinoma Mortality Pathology Rectal Neoplasms Surgery Adult Aged Aged, 80 And Over Antineoplastic Combined Chemotherapy Protocols Therapeutic Use Combined Modality Therapy Digestive System Surgical Procedures Female Fluorouracil Administration & Dosage Humans Kaplan-meier Estimate Leucovorin Male Middle Aged Neoadjuvant Therapy Neoplasm Staging Prognosis Proportional Hazards Models Radiotherapy Clinical Trial Journal Article
Content Type	Text
Resource Type	Article
Subject	Cancer Research Pathology and Forensic Medicine Oncology

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