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- Title
Clinical significance of mucinous components in rectal cancer after preoperative chemoradiotherapy.
- Authors
Kaneko, Kensuke; Kawai, Kazushige; Kazama, Shinsuke; Murono, Koji; Sasaki, Kazuhito; Yasuda, Koji; Ohtani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Nozawa, Hiroaki; Ishihara, Soichiro; Morikawa, Teppei; Fukayama, Masashi; Watanabe, Toshiaki
- Abstract
Purpose: The clinical implications of mucinous components in rectal tumors, especially with regard to the efficacy of neoadjuvant chemoradiotherapy, remain unclear. Methods: One hundred and thirty rectal cancer patients who received curative resection after neoadjuvant chemoradiotherapy were retrospectively reviewed. Patients were classified into 3 groups according to the proportion of extracellular mucin: low (<5 %), moderate (5-25 %), and high (>25 %). Results: There were 82 (63.1 %), 26 (20.0 %), and 22 (16.9 %) patients in the low, moderate, and high mucin groups, respectively. Patients with a high mucinous tumor component were significantly more likely to have an advanced tumor stage ( p = 0.010) and a shorter disease-free ( p = 0.002) and distant recurrence-free survivals ( p < 0.001), whereas the mucinous tumor component showed no correlation with local recurrence ( p = 0.101). A high mucinous component was also an independent predictive factor for a shorter disease-free survival ( p = 0.041, hazard ratio = 2.56) and distant recurrence-free survival ( p = 0.001, hazard ratio = 5.74) according to a multivariate analysis. Conclusions: Because the mucinous components showed little correlation with local recurrence, mucinous cancer should not be a determining factor for chemoradiotherapy. However, the frequent occurrence of metachronous distant metastasis among patients with a high mucin component makes this a possible indicator for more robust postoperative adjuvant treatment and close surveillance of recurrence.
- Subjects
MUCINOUS adenocarcinoma; RECTAL cancer; PREOPERATIVE care; CHEMORADIOTHERAPY; ADJUVANT treatment of cancer
- Publication
Surgery Today, 2017, Vol 47, Issue 6, p697
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-016-1419-0