Is ypTNM staging a comparable predictor as pTNM staging for survival in non-metastatic rectal cancer after preoperative chemoradiation therapy?

IF 2 4区 医学 Q3 ONCOLOGY Oncology Research Pub Date : 2024-10-16 eCollection Date: 2024-01-01 DOI:10.32604/or.2024.052098
Jen-Pin Chuang, Hsiang-Lin Tsai, Wei-Chih Su, Po-Jung Chen, Ching-Wen Huang, Tsung-Kun Chang, Yen-Cheng Chen, Ching-Chun Li, Yung-Sung Yeh, Tzu-Chieh Yin, Jaw-Yuan Wang
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Abstract

Background: The pTNM staging system is widely recognized as the most effective prognostic indicator for cancer. The latest update of this staging system introduced a new pathological staging system (ypTNM) for patients receiving neoadjuvant chemoradiotherapy (NACRT). However, whether the prognostic value of the ypTNM staging system for rectal cancer is similar to that of the pTNM staging system remains unclear. This study was conducted to compare the ypTNM and pTNM staging systems in terms of their prognostic value for patients with nonmetastatic rectal cancer undergoing proctectomy. Material and Methods: This study was conducted at a large teaching hospital. Between January 2014 and December 2022, 542 patients with rectal cancer were analyzed (median follow-up period, 60 months; range, 6-105 months). Of them, 258 and 284 were included in the pTNM and ypTNM groups, respectively. Inverse probability of treatment weighting (IPTW) was performed to account for the effects of confounders. Cox proportional-hazards regression was performed for the between-group comparison of overall survival (OS). Results: The crude model revealed that OS was similar between the two groups (p = 0.607). After performing IPTW, we found that patients with the same ypTNM- and pTNM-classified stages had similar overall survival (hazard ratio = 1.15; 95% CI = 0.76-1.73; p = 0.5074). Conclusions: For patients with rectal cancer who have received preoperative NACRT, the prognostic value of ypTNM staging appears to be similar to that of pTNM staging, mostly because of the downstaging effect of neoadjuvant chemoradiotherapy.

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ypTNM分期与pTNM分期相比,是否可预测术前化疗后非转移性直肠癌患者的生存率?
背景:pTNM分期系统是公认的最有效的癌症预后指标。该分期系统的最新更新引入了新的病理分期系统(ypTNM),适用于接受新辅助化放疗(NACRT)的患者。然而,ypTNM 分期系统对直肠癌的预后价值是否与 pTNM 分期系统相似仍不清楚。本研究旨在比较 ypTNM 和 pTNM 分期系统对接受直肠切除术的非转移性直肠癌患者的预后价值。材料与方法:本研究在一家大型教学医院进行。分析了 2014 年 1 月至 2022 年 12 月期间的 542 例直肠癌患者(中位随访期为 60 个月;范围为 6-105 个月)。其中,258 例和 284 例分别被纳入 pTNM 组和 ypTNM 组。为考虑混杂因素的影响,进行了治疗反概率加权(IPTW)。组间总生存期(OS)比较采用了 Cox 比例危险回归法。结果显示粗略模型显示,两组的 OS 相似(p = 0.607)。进行IPTW后,我们发现ypTNM分期和pTNM分期相同的患者总生存期相似(危险比=1.15;95% CI = 0.76-1.73;p = 0.5074)。结论对于术前接受了NACRT的直肠癌患者,ypTNM分期的预后价值似乎与pTNM分期相似,这主要是由于新辅助化放疗的降期效应。
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来源期刊
Oncology Research
Oncology Research 医学-肿瘤学
CiteScore
4.40
自引率
0.00%
发文量
56
审稿时长
3 months
期刊介绍: Oncology Research Featuring Preclinical and Clincal Cancer Therapeutics publishes research of the highest quality that contributes to an understanding of cancer in areas of molecular biology, cell biology, biochemistry, biophysics, genetics, biology, endocrinology, and immunology, as well as studies on the mechanism of action of carcinogens and therapeutic agents, reports dealing with cancer prevention and epidemiology, and clinical trials delineating effective new therapeutic regimens.
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