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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4032 - Prognostic factors of chemo-radiotherapy efficacy in patients with locally-advanced rectal cancer

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Mikhail Fedyanin

Citation

Annals of Oncology (2018) 29 (suppl_8): viii150-viii204. 10.1093/annonc/mdy281

Authors

M. Fedyanin1, A. Tryakin1, I. Pokataev1, A. Bulanov1, O. Sekhina1, D. Chekini1, S. Gordeev2, V. Aliev2, D. Kuzmichev2, Z. Mamedli2, Y. Barsukov2, V. Glebovskaya3, S. Tkachev3, M. Chernykh4, N. Kozlov5, S. Tjulandin1

Author affiliations

  • 1 Clinical Pharmacology And Chemotherapy, Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation., 115478 - Moscow/RU
  • 2 Surgery, Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation., 115478 - Moscow/RU
  • 3 Radiotherapy, Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation., 115478 - Moscow/RU
  • 4 Radiotherapy And Surgery, Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation., 115478 - Moscow/RU
  • 5 Morphology, Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation., 115478 - Moscow/RU
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Resources

Abstract 4032

Background

We decided to evaluate preoperative clinical factors associated with progression free survival, overall survival and tumor regression in patients with locally-advanced rectal cancer after chemo-radiotherapy.

Methods

we analyzed prospective database of patients with locally-advancded rectal cancer (cT3-4N0-2M0) who received preoperative chemo-radiotherapy followed by surgery in our center from 2004 to 2013. Multivariate regression analyses was performed to evaluate odds of absent morphological response (Dworak tumo regression rate system 0-2) and hazards of progression and deaths. Statistical analyses was performed with SPSS v.20.

Results

Chemo-radiotherapy followed by surgery was performed in 457 patients with locally-advanced rectal cancer. The median f.-up was 46 months (2-141), 3-year progression free survival and overall survival were 79% and 91%, respectively. Multivariate regression analyses revealed factors associated with tumor regression rate 0-2 as high level (above normal range) CEA (carcinoembryonic antigen) before chemo-radiotherapy (OR 1.49 95%CI 1.11-2.02, p = 0.008), neutrophils count ≥ 7,000/µl (OR 2.29, 95%CI 1.0-5.2, p=0.05) and cT4 (OR 3.73, 95%CI 2.03-6.86, p < 0.001). Independent negative prognostic factors for progression free survival were perineural invasion (HR 3.1, 95% CI 1.43-6.89, p<0,001), neutrophil/lymphocyte ratio before surgery ≥ 3 (HR 1.8, 95%CI 1.37-2.42, p=0.01) and ypT3-4 or/and N + (HR 1.82, 95%CI 0.45-0.92, p<0.01). For overall survival: ypT3-4 or/and N + (HR 1.9, 95%CI 1.3-2.65, p<0.01), lymphatic vessel invasion (HR 2.4, 95%CI 1.27-4.59, p<0.01) and leucocytes count before surgery ≥11,000/µl (HR 3.1, 95%CI 1.33-7.33, p<0.01).

Conclusions

ypTNM after preoperative chemo-radiotherapy more effective than cTNM predicts progression free and overall survival in patients with localy-advanced rectal cancer.

Clinical trial identification

Legal entity responsible for the study

Mikhail Fedyanin.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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