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Perineural invasion as a prognostic factor in rectal cancer treated with preoperative chemoradiotherapy: A multicenter retrospective study

Date

08 Oct 2016

Session

Poster Display

Presenters

Ji Won Park

Citation

Annals of Oncology (2016) 27 (6): 149-206. 10.1093/annonc/mdw370

Authors

J.W. Park1, S. Ryoo2, B.K. Park3, S. Kang4, D. Kim4, J.H. Oh3, S. Jeong2, K.J. Park2

Author affiliations

  • 1 Department Of Surgery, Seoul National University Hospital, 03080 - Seoul/KR
  • 2 Department Of Surgery, Seoul National University Hospital, Seoul/KR
  • 3 Center For Colorectal Cancer, National Cancer Center, Goyang/KR
  • 4 Department Of Surgery, Seoul National University Bundang Hospital, Seongnam-si/KR
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Background

Preoperative chemoradiotherapy is used as a standard treatment in locally advanced rectal cancer. Perineural invasion has been suggested as a poor prognostic factor in colorectal cancer. However, the prognostic role of perineural invasion for rectal cancer after preopreraitve chemoradiotherapy is not well studied in multicenter data.The aim of this study is to evaluate the prognostic impact of perineural invasion in rectal cancer treated with preopreraitve chemoradiotherapy.

Methods

From Jan 2002 to Dec 2010, 1260 patients, with locally advanced rectal cancer treated with preopreraitve chemoradiotherapy at three institutions, were included. The median radiation dose was 5040 cGy with concurrent chemotherapy. Their medical charts were retrospectively reviewed including pathology report. Survival analysis was performed to identify the clinicopatholgic factor affecting disease-free survival (DFS) and overall survival (OS).

Results

Perineural invasion was positive in 221 patients (17.5%). The patients with perineural invasion were associated with more advanced pathologic stage, less tumor regression grade, more circumferential resection involvement, more positive lymphatic invasion, and more positive venous invasion. The DFS and OS of the perineural invasion positive patients was significantly poorer than that of the perineural invasion negative patients (5-year DFS = 46.5% vs 81.1%, p 

Conclusions

Perineural invasion were associated with poor DFS and OS in rectal cancer patients who undergo preoperative chemoradiotherapy. These patients require careful monitoring after surgery.

Clinical trial identification

Legal entity responsible for the study

Ji Won Park

Funding

Seoul National University Hospital

Disclosure

All authors have declared no conflicts of interest.

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