Annals of surgery · 2006
Extent of mesorectal tumor invasion as a prognostic factor after curative surgery for T3 rectal cancer patients.
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Miyoshi Masayoshi, Ueno Hideki, Hashiguchi Yojiro, Mochizuki Hidetaka, Talbot Ian C
Аннотация
OBJECTIVE: To determine the significance of the extent of mesorectal tumor invasion as a prognostic factor for T3 rectal cancer patients.
SUMMARY BACKGROUND DATA: There is controversy as to which primary lesion characteristics, other than regional lymph node involvement, in T3 rectal cancer are reliable prognostic factors.
PATIENTS AND METHODS: The extent of mesorectal tumor invasion was evaluated using 2 data sets comprising 196 and 247 patients undergoing curative surgery at separate institutes. When the outer aspect of the muscular layer was not identifiable, an estimate was obtained by drawing a straight line between the 2 break points of the muscular layer.
RESULTS: We selected 6 mm as the optimal value for subclassification of T3 rectal patients into 2 groups, based on the extent of mesorectal invasion, using the first data set. The overall 5-year survival rate was significantly higher in patients with <6 mm than in those with > or =6 mm of mesorectal invasion (72% versus 50%; P< 0.01). Similarly, in the second data set, the overall 5-year survival rates of patients with mesorectal invasion <6 mm and > or =6 mm were 59% and 37%, respectively (P < 0.01). In both data sets, multivariate analyses verified the extent of mesorectal invasion to be an independent prognostic factor, together with nodal involvement. Regarding positive nodal involvement and mesorectal invasion > or =6 mm as risk factors, the overall 5-year survival rates with none, one, and both of these factors were 84%, 61%, and 38%, respectively, in the first data set (P < 0.01). Prognostic results were similar for the second data set.
CONCLUSION: Extent of mesorectal invasion, based on a 6-mm cutoff value, is useful for subclassification of T3 rectal cancer patients.
SUMMARY BACKGROUND DATA: There is controversy as to which primary lesion characteristics, other than regional lymph node involvement, in T3 rectal cancer are reliable prognostic factors.
PATIENTS AND METHODS: The extent of mesorectal tumor invasion was evaluated using 2 data sets comprising 196 and 247 patients undergoing curative surgery at separate institutes. When the outer aspect of the muscular layer was not identifiable, an estimate was obtained by drawing a straight line between the 2 break points of the muscular layer.
RESULTS: We selected 6 mm as the optimal value for subclassification of T3 rectal patients into 2 groups, based on the extent of mesorectal invasion, using the first data set. The overall 5-year survival rate was significantly higher in patients with <6 mm than in those with > or =6 mm of mesorectal invasion (72% versus 50%; P< 0.01). Similarly, in the second data set, the overall 5-year survival rates of patients with mesorectal invasion <6 mm and > or =6 mm were 59% and 37%, respectively (P < 0.01). In both data sets, multivariate analyses verified the extent of mesorectal invasion to be an independent prognostic factor, together with nodal involvement. Regarding positive nodal involvement and mesorectal invasion > or =6 mm as risk factors, the overall 5-year survival rates with none, one, and both of these factors were 84%, 61%, and 38%, respectively, in the first data set (P < 0.01). Prognostic results were similar for the second data set.
CONCLUSION: Extent of mesorectal invasion, based on a 6-mm cutoff value, is useful for subclassification of T3 rectal cancer patients.