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Impact of preoperative radiotherapy on survival in locally advanced rectal cancer: an observational population-based study from the South of Switzerland
- Source :
- European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP). 21(2)
- Publication Year :
- 2012
-
Abstract
- Preoperative radiotherapy (RT) followed by surgery is widely accepted in the treatment of locally advanced rectal cancer (LARC). This study aimed to estimate at the population-based level the impact of preoperative RT on overall survival (OS) and cancer-specific survival (CSS) in LARCs diagnosed in Southern Switzerland between 1996 and 2007. All patients with LARC were selected from the Ticino Cancer Registry database. Patients were categorized according to the first administered treatment: preoperative radiotherapy (RT) followed by surgery (RT+) versus surgery (RT-). Clinical-pathological characteristics and 5-year OS and CSS were analysed. Among 384 patients with LARC, 54% underwent preoperative RT, occurring more frequently in the mid-distal part of the rectum compared with the RT- group (74.8 vs. 29.8%, respectively). Both 5-year OS and CSS significantly improved in RT+ patients (OS: 68 vs. 54%, respectively; CSS: 71 vs. 63%, respectively). The adjusted hazard ratio for all death was equal to 0.66 (95% confidence interval: 0.46; 0.97); similarly, the hazard ratio for cancer-specific death was 0.63 (95% confidence interval: 0.39; 0.99). These observational population-based results, after controlling for most important diagnostic and clinical prognostic factors, confirm the benefit of preoperative RT of LARC, even if the magnitude seems greater than expected in clinical trials results. Additional studies are needed, particularly with regard to the possible effect of standardized staging procedure and multidisciplinary discussion on patient outcome.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Epidemiology
Colorectal cancer
medicine.medical_treatment
Population
Observation
Adenocarcinoma
Internal medicine
medicine
Humans
education
Survival analysis
Aged
Retrospective Studies
Aged, 80 and over
education.field_of_study
business.industry
Rectal Neoplasms
Hazard ratio
Public Health, Environmental and Occupational Health
Retrospective cohort study
Middle Aged
medicine.disease
Combined Modality Therapy
Survival Analysis
Confidence interval
Surgery
Cancer registry
Radiation therapy
Oncology
Preoperative Period
Disease Progression
Female
Radiotherapy, Adjuvant
business
Switzerland
Subjects
Details
- ISSN :
- 14735709
- Volume :
- 21
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
- Accession number :
- edsair.doi.dedup.....84b5cf86a20770d71626fc64f5162754