The negative impact of understaging rectal cancer patients.
Am J Surg
; 216(1): 93-98, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29174165
ABSTRACT
BACKGROUND:
Neo-adjuvant chemoradiation followed by surgery and adjuvant therapy is standard treatment of clinical node positive rectal cancer. Understaging leads to delay in treatment with possible detrimental results. This study analyses effects of understaging stage III rectal cancer on long-term outcomes.METHODS:
A consecutive series of patients, operated on in MGH between 2004 and 2015 was included. Outcomes of non-neoadjuvantly treated clinical stage I patients who turned out to have pathological stage III disease and neoadjuvantly treated clinical stage III patients were retrospectively reviewed. The latter group was subdivided into patients who had persistent nodal disease (ypN+) and patients without positive lymph nodes after neoadjuvant treatment (ypN0).RESULTS:
Of the 204 included patients, 30 had unexpected nodal disease on pathology. Clinical stage I-patients had higher rates of local recurrence, and rectal cancer and overall mortality than ypN0-patients.CONCLUSION:
Understaging stage III rectal cancer led to poorer oncologic outcomes, when compared to patients without positive lymph nodes on pathology after neoadjuvant. Future research should focus on identifying patients with treatment susceptible lymph node involvement.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
2_muertes_prematuras_enfermedades_notrasmisibles
/
6_colon_rectum_cancers
Assunto principal:
Neoplasias Retais
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Adenocarcinoma
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Educação de Pacientes como Assunto
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Estadiamento de Neoplasias
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos