Oncotarget

Clinical Research Papers:

Tumor deposits: markers of poor prognosis in patients with locally advanced rectal cancer following neoadjuvant chemoradiotherapy

Lu-Ning Zhang, Wei-Wei Xiao, Shao-Yan Xi, Pu-Yun OuYang, Kai-Yun You, Zhi-Fan Zeng, Pei-Rong Ding, Hui-Zhong Zhang, Zhi-Zhong Pan, Rui-Hua Xu and Yuan-Hong Gao _

PDF  |  HTML  |  How to cite  |  Order a Reprint

Oncotarget. 2016; 7:6335-6344. https://doi.org/10.18632/oncotarget.6656

Metrics: PDF 1425 views  |   HTML 1657 views  |   ?  


Abstract

Lu-Ning Zhang1,*, Wei-Wei Xiao1,*, Shao-Yan Xi4,*, Pu-Yun OuYang1,*, Kai-Yun You5, Zhi-Fan Zeng1, Pei-Rong Ding2, Hui-Zhong Zhang4, Zhi-Zhong Pan2, Rui-Hua Xu3,** and Yuan-Hong Gao1,**

1 Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China

2 Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China

3 Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China

4 Department of Pathological Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China

5 Department of Oncology, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China

* Co-first authors

** Co-senior authors

Correspondence to:

Yuan-Hong Gao, email:

Rui-Hua Xu, email:

Keywords: adjuvant chemotherapy; locally advanced rectal cancer; neoadjuvant chemoradiotherapy; prognosis; tumor deposits

Received: July 20, 2015 Accepted: November 25, 2015 Published: December 18, 2015

Abstract

Background: Tumor deposits (TDs) were reported to be poor prognoses in colorectal carcinoma, but the significance in locally advanced rectal cancer (LARC) (T3-4/N+) following neoadjuvant chemoradiotherapy (neo-CRT) and surgery is unclear. Since adjuvant chemotherapy showed no benefit for LARC following neo-CRT, it is of great value to investigate whether TDs can identify the subgroup of patients who may benefit from adjuvant chemotherapy.

Methods: Between 2004 and 2012, 310 LARC patients following neo-CRT and surgery were retrospectively reviewed. Overall survival (OS), disease-free survival (DFS), distant metastasis free survival (DMFS) and local recurrence free survival (LRFS) were evaluated by Kaplan-Meier method, log-rank test and Cox models.

Results: TDs-positive patients showed adverse OS, DFS and DMFS (all P≤0.001), but not LRFS (P = 0.273). In multivariate analysis, TDs continued to be associated with poor OS (HR = 2.44, 95% CI 1.32-4.4, P = 0.004) and DFS (HR = 1.99, 95% CI 1.21-3.27, P = 0.007), but not DMFS (HR = 1.77, 95% CI 0.97-3.20, P = 0.061) or LRFS (HR = 1.85, 95% CI 0.58-5.85, P = 0.298). Among TDs-positive patients, adjuvant chemotherapy significantly improved OS (P = 0.045) and DMFS (P = 0.026), but not DFS (P = 0.127) or LRFS (P = 0.862).

Conclusions: TDs are predictive of poor survival in LARC after neo-CRT. Fortunately, TDs-positive patients appear to benefit from adjuvant chemotherapy.


Creative Commons License All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License.
PII: 6656