Textbook outcome in low rectal cancer after neoadjuvant chemoradiotherapy: Post hoc analysis of the LASRE randomized clinical trial.
Eur J Surg Oncol
; 50(9): 108519, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-38950491
ABSTRACT
BACKGROUND:
Textbook outcome has been incorporated into quality assessment measures in various oncological settings; however, it has not been applied to patients with low rectal cancer after neoadjuvant chemoradiotherapy (nCRT). This study aimed to examine the prevalence and predictors of achieving a textbook outcome in patients undergoing surgical resection of low rectal cancer after nCRT. PATIENTS ANDMETHODS:
This study was a post hoc subgroup analysis of the prospective multicentric LASRE trial, which specifically enrolled patients with rectal cancer located within 5 cm from the dentate line at diagnosis, tumors with diameters less than 6 cm, and patients who underwent radical laparoscopic or open resection. A total of 597 patients who had clinically staged cT3-4aN0-2M0 tumors with diameters less than 6 cm and who underwent neoadjuvant chemoradiotherapy followed by radical resection were included.RESULTS:
Textbook outcome was achieved in 60.0 % of patients. Multivariate logistic regression analysis revealed that body mass index >25 kg/m2 (OR = 0.594, P = 0.01), tumor distance from the anal verge >40 mm (OR = 5.518, P < 0.001), operative time >202 min (OR = 0.675, P = 0.04), and laparoscopic approach (OR = 1.497, P = 0.04) were independently predictive factors for the achievement of a textbook outcome in low rectal cancer patients undergoing nCRT and radical resection. A predictive nomogram for achieving a textbook outcome was constructed, yielding a C-index of 0.727.CONCLUSIONS:
Laparoscopic resection exhibited promising potential in improving the probability of achieving a textbook outcome.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Neoplasias del Recto
/
Terapia Neoadyuvante
Límite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur J Surg Oncol
/
Eur. j. surg. oncol
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European journal of surgical oncology
Asunto de la revista:
NEOPLASIAS
Año:
2024
Tipo del documento:
Article