Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Stage II/III rectal cancer with intermediate response to preoperative radiochemotherapy: Do we have indications for individual risk stratification? | Sprenger et al. World Journal of Surgical Oncology 2010 8 27 http content 8 1 27 RESEARCH WORLD JOURNAL OF SURGICAL ONCOLOGY Open Access Stage II III rectal cancer with intermediate response to preoperative radiochemotherapy Do we have indications for individual risk stratification Thilo Sprenger 1 Hilka Rothe2 Klaus Jung3 Hans Christiansen4 Lena C Conradi1 B Michael Ghadimi1 Heinz Becker1 and Torsten Liersch1 Abstract Background Response to preoperative radiochemotherapy RCT in patients with locally advanced rectal cancer is very heterogeneous. Pathologic complete response pCR is accompanied by a favorable outcome. However most patients show incomplete response. The aim of this investigation was to find indications for risk stratification in the group of intermediate responders to RCT. Methods From a prospective database of 496 patients with rectal adenocarcinoma 107 patients with stage II III cancers and intermediate response to preoperative 5-FU based RCT ypT2 3 and TRG 2 3 treated within the German Rectal Cancer Trials were studied. Surgical treatment comprised curative R0 total mesorectal excision TME in all cases. In 95 patients available for statistical analyses residual transmural infiltration of the mesorectal compartment nodal involvement and histolologic tumor grading were investigated for their prognostic impact on disease-free DFS and overall survival OS . Results Residual tumor transgression into the mesorectal compartment ypT3 did not influence DFS and OS rates p p respectively . Nodal involvement after preoperative RCT ypN1 2 turned out to be a valid prognostic factor with decreased DFS and OS p p respectively . Persistent tumor infiltration of the mesorectum ypT3 and histologic tumor grading of residual tumor cell clusters were strongly correlated with lymph node metastases after neoadjuvant treatment p . Conclusions Advanced transmural tumor invasion after RCT does not affect prognosis when curative R0
