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Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer: A Propensity Score Analysis.
Medicine (Baltimore). 2016 May; 95(20):e3718.M

Abstract

Good oncologic outcomes, demonstrated by a complete pathologic response after preoperative chemoradiotherapy (PCRT), have led to local excision (LE) in selected patients with rectal cancer. We evaluated the oncologic safety of LE compared with total mesorectal excision (TME) in patients with ypT0-T1 rectal cancer.A retrospective review of 304 patients who underwent PCRT, followed by LE or TME, for ypT0-T1 rectal cancer was performed. Propensity scores were computed and used to match groups (LE:TME = 1:1), and analysis of disease-free survival (DFS) and overall survival (OS) was made by comparing patients who underwent LE or TME. Prognostic factors of relapse were analyzed for all patients.Tumor categories were ypT0 in 25 (61.9%) cases, ypTis in 6 (14.3%) cases, and ypT1 in 11 (26.2%) cases for the LE group, and ypT0 in 28 (66.7%) cases, ypTis in 4 (9.5%) cases, and ypT1 in 10 (23.8%) cases for the matched TME patients. There was no significant difference between the matched LE and TME groups in relapse (4.8% and 7.14%, respectively; P = 0.646), 5-year DFS (95.2% vs 91.6%; P = 0.33) and 5-year OS (96.6% vs 88.0%; P = 0.238). In the multivariate Cox regression analysis, tumor distance from the anal verge (hazard ratio [HR] = 0.78; 95% confidence interval (CI) = 0.616-0.992) and the tumor grade (HR = 4.29; 95% CI = 1.430-12.886) were significantly associated with the recurrence risk.LE results in oncologic outcomes that are comparable to those achieved by TME in selected patients with ypT0-T1 rectal cancer after PCRT.

Authors+Show Affiliations

From the Department of Colon and Rectal Surgery (SMJ, CSY, IJP, YSY, SBL, JCK), Department of Oncology (TWK), and Department of Radiation Oncology (JHK), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.No 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

Language

eng

PubMed ID

27196490

Citation

Jung, Sung Min, et al. "Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer: a Propensity Score Analysis." Medicine, vol. 95, no. 20, 2016, pp. e3718.
Jung SM, Yu CS, Park IJ, et al. Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer: A Propensity Score Analysis. Medicine (Baltimore). 2016;95(20):e3718.
Jung, S. M., Yu, C. S., Park, I. J., Kim, T. W., Kim, J. H., Yoon, Y. S., Lim, S. B., & Kim, J. C. (2016). Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer: A Propensity Score Analysis. Medicine, 95(20), e3718. https://doi.org/10.1097/MD.0000000000003718
Jung SM, et al. Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer: a Propensity Score Analysis. Medicine (Baltimore). 2016;95(20):e3718. PubMed PMID: 27196490.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oncologic Safety of Local Excision Compared With Total Mesorectal Excision for ypT0-T1 Rectal Cancer: A Propensity Score Analysis. AU - Jung,Sung Min, AU - Yu,Chang Sik, AU - Park,In Ja, AU - Kim,Tae Won, AU - Kim,Jong Hoon, AU - Yoon,Yong Sik, AU - Lim,Seok-Byung, AU - Kim,Jin Cheon, PY - 2016/5/20/entrez PY - 2016/5/20/pubmed PY - 2017/2/22/medline SP - e3718 EP - e3718 JF - Medicine JO - Medicine (Baltimore) VL - 95 IS - 20 N2 - Good oncologic outcomes, demonstrated by a complete pathologic response after preoperative chemoradiotherapy (PCRT), have led to local excision (LE) in selected patients with rectal cancer. We evaluated the oncologic safety of LE compared with total mesorectal excision (TME) in patients with ypT0-T1 rectal cancer.A retrospective review of 304 patients who underwent PCRT, followed by LE or TME, for ypT0-T1 rectal cancer was performed. Propensity scores were computed and used to match groups (LE:TME = 1:1), and analysis of disease-free survival (DFS) and overall survival (OS) was made by comparing patients who underwent LE or TME. Prognostic factors of relapse were analyzed for all patients.Tumor categories were ypT0 in 25 (61.9%) cases, ypTis in 6 (14.3%) cases, and ypT1 in 11 (26.2%) cases for the LE group, and ypT0 in 28 (66.7%) cases, ypTis in 4 (9.5%) cases, and ypT1 in 10 (23.8%) cases for the matched TME patients. There was no significant difference between the matched LE and TME groups in relapse (4.8% and 7.14%, respectively; P = 0.646), 5-year DFS (95.2% vs 91.6%; P = 0.33) and 5-year OS (96.6% vs 88.0%; P = 0.238). In the multivariate Cox regression analysis, tumor distance from the anal verge (hazard ratio [HR] = 0.78; 95% confidence interval (CI) = 0.616-0.992) and the tumor grade (HR = 4.29; 95% CI = 1.430-12.886) were significantly associated with the recurrence risk.LE results in oncologic outcomes that are comparable to those achieved by TME in selected patients with ypT0-T1 rectal cancer after PCRT. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/27196490/Oncologic_Safety_of_Local_Excision_Compared_With_Total_Mesorectal_Excision_for_ypT0_T1_Rectal_Cancer:_A_Propensity_Score_Analysis_ L2 - http://dx.doi.org/10.1097/MD.0000000000003718 DB - PRIME DP - Unbound Medicine ER -