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Treatment outcomes of patients with involved resection margin after rectal cancer surgery: A nationwide population-based cohort study in South Korea

Authors
Bong, Jun WooLee, Jung AeJu, YeonukSeo, JihyunKang, Sang HeeLee, Sun IlMin, Byung Wook
Issue Date
Aug-2022
Publisher
Blackwell Pub. Asia
Keywords
adjuvant therapy; rectal cancer; resection margin; surgery; treatment outcome
Citation
Asia-Pacific Journal of Clinical Oncology, v.18, no.4, pp.378 - 387
Indexed
SCIE
SCOPUS
Journal Title
Asia-Pacific Journal of Clinical Oncology
Volume
18
Number
4
Start Page
378
End Page
387
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/53910
DOI
10.1111/ajco.13608
ISSN
1743-7555
Abstract
Background The involvement of resection margins after rectal cancer surgery by malignant tumors is a negative prognostic factor. Therefore, it is important to analyze treatment outcomes and establish adjuvant therapy. Methods The Health Insurance Review and Assessment Service collects data from medical institutions in South Korea. We reviewed the database of this prospectively collected cohort for patients who underwent curative resection for rectal cancer. Results Of the 5,620 patients, 113 (2.0%) were diagnosed with resection margin involvement after surgery. The resection margins of patients with mid-rectal cancer, pathologic stage III, mucinous/signet ring cell carcinoma, and undergoing emergency surgery were more frequently involved. Neoadjuvant chemoradiotherapy was a significant preventive factor for resection margin involvement (odds ratio = 0.53; 95% confidence interval [CI], 0.32–0.87; p = 0.012). The OS of patients with adjuvant treatment was better than that of patients without adjuvant treatment (5-year overall survival [OS]: 62.8% vs. 46.3%, p = 0.02). The administration of chemoradiotherapy was also significantly associated with better OS (hazard ratio = 0.36; 95% CI, 0.17–0.77; p = 0.009). Conclusion Efforts to acquire wider resection margins are necessary for patients with mid-rectal cancer, pathologic stage III, mucinous/signet ring cell carcinoma, and emergency surgery. Neoadjuvant chemoradiotherapy was a significant preventive factor for involved resection margin. Patients with resection margin involvement showed better OS after adjuvant treatment than those without adjuvant treatment. The adjuvant chemoradiotherapy was helpful to prevent the worse prognosis of these patients.
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2. Clinical Science > Department of Radiation Oncology > 1. Journal Articles
2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles

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구로병원 (Department of Colon and Rectal Surgery, Guro Hospital)
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