Tumor volume predicts local recurrence in early rectal cancer treated with radical resection: A retrospective observational study of 270 patients. (January 2018)

• Record Type: Journal Article
• Authors: Jiang, Yanhui; You, Kaiyun; Qiu, Xingsheng; Bi, Zhuofei; Mo, Huaqian; Li, Liting; Liu, Yimin
• Is Part Of: International journal of surgery. Volume 49(2018)
• Page Start: 68
• Page End: 73
• Publication Date: 2018-01
• Subjects: Early rectal cancer -- Radical resection -- Tumor volume -- Overall survival -- Recurrence; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2017.11.052
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Objective: Radical resection is regarded as the primary treatment for early rectal cancer, and tumor volume is an independent predictor of many other types of cancer. The purpose of the present study is to assess the effect of tumor volume on the survival of patients with early rectal cancer treated with radical surgery. Methods: A total of 270 patients with histologically confirmed stage T1/2 N0 rectal cancer who underwent radical resection between September 2006 and September 2014 were enrolled in this study. The tumor volume was measured based on the preoperative pelvic MRI. The clinical significance of tumor volume with respect to patients' outcomes was evaluated, and the multivariate Cox proportional regression model was used to analyse the risk factors for survival of these patients. Results: The median follow-up period was 57.6 months. The tumor volume was significantly correlated with preoperative Hb, CEA level and number of retrieved lymph nodes (all p < 0.05). The large tumor group had a lower disease-free survival (DFS) rate than the small tumor group (5-year DFS rate: 80.4% vs 89.6%, p = 0.042), whereas there was no difference in the overall survival rate. The 5-year local recurrence rates for patients in the large and small tumor groups were 10.5% and 3.0%, respectively (p = 0.030). Additionally, the tumor volume was an independent clinical predictor for both DFS and local recurrence-free survival (LRFS). Conclusion: In conclusion, the tumor volume is significantly associated with DFS and LRFS of patients with stage T1/2 N0 rectal cancer who underwent radical resection alone. Tumor volume may be considered an important indicator for neoadjuvant or adjuvant therapeutic interventions. Highlights: Tumor volume is superior to tumor size as a prognostic classifier in cancer. Tumor volume is a novel prognostic factors in stage T1/2 N0 rectal cancer treated with radical resection. Using tumor volume to evaluate the outcome of cancer patients is worthy to be popularized.