Postoperative 5-FU based radiochemotherapy in rectal cancer: retrospective long term results and prognostic factors of a pooled analysis on 1,338 patients

Anticancer Res. 2013 Oct;33(10):4557-66.

Abstract

Aim: To evaluate survival outcomes of patients in pStage II-III rectal cancer treated with adjuvant 5-fluorouracil-based radiochemotherapy and to retrospectively analyze the impact of prognostic variables on local control, metastasis-free survival and cause-specific survival.

Patients and methods: A total of 1,338 patients, treated between 1985-2005 for locally advanced rectal cancer, who underwent surgery and postoperative 5-fluorouracil-based chemoradiation, were selected.

Results: The actuarial 5- and 10-year outcomes were: local control 87.0%-84.1%, disease-free survival 61.6%-52.1%, metastasis-free survival 72.0%-67.2%, cause-specific survival 70.4%-57.5%, and overall survival 63.8%-53.4%. Better outcomes were observed in patients with IIA, IIIA stage. Multivariate analyses showed that variables significantly affecting metastasis-free survival were pT4 and pN2, while for cancer-specific survival those variables were age >65 years, pT4, pN1, pN2, distal tumors and number of lymph nodes removed ≤ 12.

Conclusion: This study confirmed that among stage II-III rectal cancer patients there are subgroups of patients with different clinical outcomes.

Keywords: Rectal cancer; adjuvant therapy; prognostic factors; staging.

MeSH terms

  • Antimetabolites, Antineoplastic / therapeutic use*
  • Chemoradiotherapy
  • Disease-Free Survival
  • Fluorouracil / therapeutic use*
  • Humans
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Postoperative Period
  • Prognosis
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antimetabolites, Antineoplastic
  • Fluorouracil