Clinical Research Papers:

Implications for selecting local excision in locally advanced rectal cancer after preoperative chemoradiation

Juefeng Wan _, Kaitai Liu, Ji Zhu, Guichao Li and Zhen Zhang

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Oncotarget. 2015; 6:11714-11722. https://doi.org/10.18632/oncotarget.3418

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Juefeng Wan1,2,*, Kaitai Liu3,*, Ji Zhu1,2, Guichao Li1,2, Zhen Zhang1,2

1Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China

2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

3Department of Radiation Oncology, Lihuili Hospital, Ningbo Medical Center, Ningbo, China

*These authors have contributed equally to this work

Correspondence to:

Zhen Zhang, e-mail: [email protected]

Keywords: rectal cancer, local excision, positive lymph nodes, chemoradiotherapy, seer

Received: January 28, 2015     Accepted: February 19, 2015     Published: March 23, 2015


Local excision may offer the possibility of organ preservation for the management of locally advanced rectal cancer after neoadjuvant chemoradiotherapy (CRT). However, the oncological outcomes of this strategy have been largely associated with the risk of nodal metastases. In this study, Surveillance, Epidemiology, and End Results Program (SEER)-registered rectal cancer patients, and patients from Fudan University Shanghai Cancer Center (FUSCC) after preoperative chemoradiation were combined to analyze the incidence of lymph node metastasis. The results showed that there was a high risk for residual lymph node metastasis among patients even with complete pathologic response of primary tumor after preoperative CRT (12.6–13.2%). However, in the selected group of patients with pre-CRT MRI staging cN0 rectal cancer, there was only one ypN+ case (3.3%) in ypT0–1 group. These results suggest that pre-CRT MRI staging cN0 patients achieved ypT0–1 of bowel wall tumor may be suitable for local resection.

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