Model predicting the ypN0 status after good response to chemoradiotherapy in rectal cancer

F. Dumont; P. Dartigues; B. Delga; E. Thibaudeau; L. Benhaim; L. Campion; J. F. Mosnier; J. Raimbourg; O. Kerdraon; D. Goéré

doi:10.1016/j.amjsurg.2018.03.025

Model predicting the ypN0 status after good response to chemoradiotherapy in rectal cancer

F. Dumont, P. Dartigues, B. Delga, E. Thibaudeau, L. Benhaim, L. Campion, J. F. Mosnier, J. Raimbourg, O. Kerdraon, D. Goéré

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Résumé

Background: The purpose of this study was to identify the predictive factors for ypN0 status in tumors with good pathologic response to chemoradiotherapy (CRT). Methods: A retrospective chart review was conducted on patients at two tertiary cancer center who underwent rectal resection after good response to CRT between 2000 and 2013. Results: No preoperative treatment (oxaliplatin use, radiotherapy boost of 5,4 Gy, delay CRT-surgery) impacted on the ypN status. In the multivariate analysis, only a ypT<3 (HR 7.5 [2,9–19.5]) was significant and no lymphovascular invasion (HR 8,9 [1.6–49.8]) was limited to significance.The best model predicting the ypN0 status used only the ypT status<3. The major part (92.2%) of patients with ypT0-2 tumors had no LN invasion. Conclusion: The risk of lymph node involvement metastases was only 7.8% for the patients with an ypT0-2 status. A fullthickness transanal resection coud be the futur treatment of these patients.

langue originale	Anglais
Pages (de - à)	438-443
Nombre de pages	6
journal	American Journal of Surgery
Volume	216
Numéro de publication	3
Les DOIs	https://doi.org/10.1016/j.amjsurg.2018.03.025
état	Publié - 1 sept. 2018

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10.1016/j.amjsurg.2018.03.025

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@article{f074cb72be634bc3b1f84a0f0c3cabe1,

title = "Model predicting the ypN0 status after good response to chemoradiotherapy in rectal cancer",

abstract = "Background: The purpose of this study was to identify the predictive factors for ypN0 status in tumors with good pathologic response to chemoradiotherapy (CRT). Methods: A retrospective chart review was conducted on patients at two tertiary cancer center who underwent rectal resection after good response to CRT between 2000 and 2013. Results: No preoperative treatment (oxaliplatin use, radiotherapy boost of 5,4 Gy, delay CRT-surgery) impacted on the ypN status. In the multivariate analysis, only a ypT<3 (HR 7.5 [2,9–19.5]) was significant and no lymphovascular invasion (HR 8,9 [1.6–49.8]) was limited to significance.The best model predicting the ypN0 status used only the ypT status<3. The major part (92.2%) of patients with ypT0-2 tumors had no LN invasion. Conclusion: The risk of lymph node involvement metastases was only 7.8% for the patients with an ypT0-2 status. A fullthickness transanal resection coud be the futur treatment of these patients.",

keywords = "Chemoradiotherapy, Chemoradiotherapy T status, Good response, Lymph node, Nodal staging, Rectal cancer",

author = "F. Dumont and P. Dartigues and B. Delga and E. Thibaudeau and L. Benhaim and L. Campion and Mosnier, {J. F.} and J. Raimbourg and O. Kerdraon and D. Go{\'e}r{\'e}",

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year = "2018",

month = sep,

day = "1",

doi = "10.1016/j.amjsurg.2018.03.025",

language = "English",

volume = "216",

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T1 - Model predicting the ypN0 status after good response to chemoradiotherapy in rectal cancer

AU - Dumont, F.

AU - Dartigues, P.

AU - Delga, B.

AU - Thibaudeau, E.

AU - Benhaim, L.

AU - Campion, L.

AU - Mosnier, J. F.

AU - Raimbourg, J.

AU - Kerdraon, O.

AU - Goéré, D.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: The purpose of this study was to identify the predictive factors for ypN0 status in tumors with good pathologic response to chemoradiotherapy (CRT). Methods: A retrospective chart review was conducted on patients at two tertiary cancer center who underwent rectal resection after good response to CRT between 2000 and 2013. Results: No preoperative treatment (oxaliplatin use, radiotherapy boost of 5,4 Gy, delay CRT-surgery) impacted on the ypN status. In the multivariate analysis, only a ypT<3 (HR 7.5 [2,9–19.5]) was significant and no lymphovascular invasion (HR 8,9 [1.6–49.8]) was limited to significance.The best model predicting the ypN0 status used only the ypT status<3. The major part (92.2%) of patients with ypT0-2 tumors had no LN invasion. Conclusion: The risk of lymph node involvement metastases was only 7.8% for the patients with an ypT0-2 status. A fullthickness transanal resection coud be the futur treatment of these patients.

AB - Background: The purpose of this study was to identify the predictive factors for ypN0 status in tumors with good pathologic response to chemoradiotherapy (CRT). Methods: A retrospective chart review was conducted on patients at two tertiary cancer center who underwent rectal resection after good response to CRT between 2000 and 2013. Results: No preoperative treatment (oxaliplatin use, radiotherapy boost of 5,4 Gy, delay CRT-surgery) impacted on the ypN status. In the multivariate analysis, only a ypT<3 (HR 7.5 [2,9–19.5]) was significant and no lymphovascular invasion (HR 8,9 [1.6–49.8]) was limited to significance.The best model predicting the ypN0 status used only the ypT status<3. The major part (92.2%) of patients with ypT0-2 tumors had no LN invasion. Conclusion: The risk of lymph node involvement metastases was only 7.8% for the patients with an ypT0-2 status. A fullthickness transanal resection coud be the futur treatment of these patients.

KW - Chemoradiotherapy

KW - Chemoradiotherapy T status

KW - Good response

KW - Lymph node

KW - Nodal staging

KW - Rectal cancer

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