Significance of histologic tumor grade in rectal cancer treated with preoperative chemoradiotherapy followed by curative surgery: A multi-institutional retrospective study

Jin Ho Song, Sung Hwan Kim, Jong Hoon Lee, Hyeon Min Cho, Dae Yong Kim, Tae Hyun Kim, Sun Young Kim, Ji Yeon Baek, Jae Hwan Oh, Taek Keun Nam, Mee Sun Yoon, Jae Uk Jeong, Kyubo Kim, Eui Kyu Chie, Hong Seok Jang, Jae Sung Kim, Jin Hee Kim, Ki Mun Kang

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15 Scopus citations

Abstract

Background and purpose To evaluate the pre-treatment clinical factors affecting recurrence and survival in rectal cancer patients who receive preoperative chemoradiotherapy (CRT) and curative surgery. Methods and materials The clinical data of 1782 patients from 8 institutions in Korea were analyzed. The potential prognostic factors that could be acquired before radical surgery were patient age, gender, clinical T and N stages, tumor size and location, tumor grade, carcinoembryonic antigen (CEA) level, and the concurrent chemotherapy regimen. The relapse-free survival (RFS), overall survival (OS), and cumulative incidence of locoregional and distant recurrence were analyzed according to the clinical factors. Results Among the pre-treatment clinical factors, tumor grade, pre-CRT CEA level, tumor location, and clinical N stage were significant prognostic factors affecting the RFS. The high-grade tumor was the hazardous factor for RFS on the multivariate analysis [Hazard ratio (HR), 1.83; 95% confidence interval (CI), 1.29-2.58; p = 0.001]. The 5-year RFS rate for high-grade tumors was significantly lower than that for low-grade tumors (63.8% vs. 78.8%, p < 0.001). The tumor grade was a significant prognostic factor for distant recurrence (HR, 1.83, 95% CI, 1.29-2.58; p < 0.001), but not for locoregional recurrence (HR, 1.49, 95% CI, 0.68-3.26; p = 0.320) on the multivariate analysis. The 5-year OS rate for high-grade tumors was significantly lower than that for low-grade tumors (70.6% vs. 85.5%, p < 0.001). Conclusion The tumor grade is the significant pre-treatment clinical factor for recurrence and survival in rectal cancer patients who receive preoperative CRT and curative surgery.

Original languageEnglish
Pages (from-to)387-392
Number of pages6
JournalRadiotherapy and Oncology
Volume118
Issue number2
DOIs
StatePublished - 1 Feb 2016

Bibliographical note

Publisher Copyright:
© 2015 Elsevier Ireland Ltd.

Keywords

  • Grade
  • Histology
  • Neoplasm
  • Prognosis
  • Rectum

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