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Lymphovascular invasion is a significant prognosticator in rectal cancer patients who receive preoperative chemoradiotherapy followed by total mesorectal excision.
Ann Surg Oncol. 2012 Apr; 19(4):1213-21.AS

Abstract

PURPOSE

This study was designed to identify the significance of lymphovascular invasion as a prognosticator for tumor recurrence and survival in rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and total mesorectal excision (TME).

METHODS

Between January 2003 and October 2010, the study included 328 patients with primary rectal cancer who had received preoperative CRT followed by TME. We analyzed the clinicopathologic factors that may be associated with survival, such as age, gender, carcinoembryonic antigen (CEA) value, pathologic T and N stage, tumor response, histologic grade, lymphovascular invasion (LVI), and perineural invasion.

RESULTS

Higher pathologic T and N stage, poor tumor response, high-grade histology, and positive LVI were adverse prognostic factors for both disease-free survival (DFS) and overall survival (OS) on the multivariate analysis. Perineural invasion was a significant adverse prognostic factor affecting DFS (P=0.046) but not OS (P=0.08). Increased T and N stage and distant recurrence, but not local recurrence, were significant factors associated with LVI. The LVI-negative group had a higher DFS (71.4 vs. 56.2%, P=0.012) and OS rate (86.7 vs. 63.4%, P=0.020) at 5 years than the LVI-positive group did.

CONCLUSIONS

Positive LVI had a negative impact on survival in patients with rectal cancer who received preoperative CRT and TME and is significantly associated with an increased chance of distant recurrence. Based on this finding, more tailored adjuvant chemotherapy is warranted for advanced rectal cancer patients with LVI to reduce the distant dissemination of tumor.

Authors+Show Affiliations

Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21935746

Citation

Lee, Jong Hoon, et al. "Lymphovascular Invasion Is a Significant Prognosticator in Rectal Cancer Patients Who Receive Preoperative Chemoradiotherapy Followed By Total Mesorectal Excision." Annals of Surgical Oncology, vol. 19, no. 4, 2012, pp. 1213-21.
Lee JH, Jang HS, Kim JG, et al. Lymphovascular invasion is a significant prognosticator in rectal cancer patients who receive preoperative chemoradiotherapy followed by total mesorectal excision. Ann Surg Oncol. 2012;19(4):1213-21.
Lee, J. H., Jang, H. S., Kim, J. G., Cho, H. M., Shim, B. Y., Oh, S. T., Yoon, S. C., Kim, Y. S., Choi, B. O., & Kim, S. H. (2012). Lymphovascular invasion is a significant prognosticator in rectal cancer patients who receive preoperative chemoradiotherapy followed by total mesorectal excision. Annals of Surgical Oncology, 19(4), 1213-21. https://doi.org/10.1245/s10434-011-2062-z
Lee JH, et al. Lymphovascular Invasion Is a Significant Prognosticator in Rectal Cancer Patients Who Receive Preoperative Chemoradiotherapy Followed By Total Mesorectal Excision. Ann Surg Oncol. 2012;19(4):1213-21. PubMed PMID: 21935746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymphovascular invasion is a significant prognosticator in rectal cancer patients who receive preoperative chemoradiotherapy followed by total mesorectal excision. AU - Lee,Jong Hoon, AU - Jang,Hong Seok, AU - Kim,Jun-Gi, AU - Cho,Hyun Min, AU - Shim,Byoung Yong, AU - Oh,Seong Taek, AU - Yoon,Sei-Chul, AU - Kim,Yeon-Sil, AU - Choi,Byung Ock, AU - Kim,Sung Hwan, Y1 - 2011/09/21/ PY - 2011/04/27/received PY - 2011/9/22/entrez PY - 2011/9/22/pubmed PY - 2012/7/24/medline SP - 1213 EP - 21 JF - Annals of surgical oncology JO - Ann. Surg. Oncol. VL - 19 IS - 4 N2 - PURPOSE: This study was designed to identify the significance of lymphovascular invasion as a prognosticator for tumor recurrence and survival in rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and total mesorectal excision (TME). METHODS: Between January 2003 and October 2010, the study included 328 patients with primary rectal cancer who had received preoperative CRT followed by TME. We analyzed the clinicopathologic factors that may be associated with survival, such as age, gender, carcinoembryonic antigen (CEA) value, pathologic T and N stage, tumor response, histologic grade, lymphovascular invasion (LVI), and perineural invasion. RESULTS: Higher pathologic T and N stage, poor tumor response, high-grade histology, and positive LVI were adverse prognostic factors for both disease-free survival (DFS) and overall survival (OS) on the multivariate analysis. Perineural invasion was a significant adverse prognostic factor affecting DFS (P=0.046) but not OS (P=0.08). Increased T and N stage and distant recurrence, but not local recurrence, were significant factors associated with LVI. The LVI-negative group had a higher DFS (71.4 vs. 56.2%, P=0.012) and OS rate (86.7 vs. 63.4%, P=0.020) at 5 years than the LVI-positive group did. CONCLUSIONS: Positive LVI had a negative impact on survival in patients with rectal cancer who received preoperative CRT and TME and is significantly associated with an increased chance of distant recurrence. Based on this finding, more tailored adjuvant chemotherapy is warranted for advanced rectal cancer patients with LVI to reduce the distant dissemination of tumor. SN - 1534-4681 UR - https://www.unboundmedicine.com/medline/citation/21935746/Lymphovascular_invasion_is_a_significant_prognosticator_in_rectal_cancer_patients_who_receive_preoperative_chemoradiotherapy_followed_by_total_mesorectal_excision_ L2 - https://dx.doi.org/10.1245/s10434-011-2062-z DB - PRIME DP - Unbound Medicine ER -