Rectal cancer treatment without neoadjuvant chemoradiation based on preoperative magnetic resonance imaging: Determinants of surgical quality in the German OCUM study
| العنوان: | Rectal cancer treatment without neoadjuvant chemoradiation based on preoperative magnetic resonance imaging: Determinants of surgical quality in the German OCUM study |
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| المؤلفون: | Joachim Strassburg, Henry Ptok, Susanne Merkel, Martin E. Kreis, Paul Hermanek, Theodor Junginger, Reinhard Ruppert |
| المصدر: | Journal of Clinical Oncology. 32:526-526 |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Cancer Research, Preoperative chemoradiotherapy, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Colorectal cancer, Magnetic resonance imaging, medicine.disease, Total mesorectal excision, Acs nsqip, Surgery, Tumor perforation, Oncology, medicine, In patient, business, Cohort study |
| الوصف: | 526 Background: Preoperative chemoradiation adds functional impairment to patients undergoing total mesorectal excision (TME). Surgical quality is of paramount importance to achieve low local recurrence rates in patients operated without preoperative chemoradiation when a negative circumferential margin was shown by preoperative magnetic resonance imaging (MRI). We aimed to determine surgical quality in a prospective multicenter cohort study (OCUM) in patients selected by MRI for surgery without neoadjuvant chemoradiation. Methods: Quality of TME was assessed in three categories for 282 patients from 12 hospitals enrolled for surgery without preoperative chemoradiation (Nagtegaal et al. 2005, Quirke and Morris 2007). Tumor perforation, local tumor cell dissemination and number of lymph nodes were assessed. Further, negative predictive value of MRI for histopathological involvement of the circumferential margin was determined. Results: In patients undergoing TME the muscularis propria plane (category III) was reached in 1/282 patients (0,4 %). Intraoperative tumor cell dissemination was observed in 3/282 patients (1,1 %). Total number of lymph nodes was 25 (median, range 10-79) and 79/282 patients had positive lymph nodes (28 %). The number of 12 lymph nodes recommended by UICC was not reached in one patient. Preoperative MRI correctly predicted a negative circumferential margin involvement as determined by histopathological workup in 98,9 % of patients. Conclusions: Excellent results in terms of surgical quality are possible justifying surgery without pretreatment in patients with MRI-negative circumferental margin tumors. This concept avoids additional functional impairment and reduced quality of life following preoperative chemoradiation in selected patients. Clinical trial information: NCT01325649. |
| تدمد: | 1527-7755 0732-183X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::37e86839d594c665f2af9a196879394cTest https://doi.org/10.1200/jco.2014.32.3_suppl.526Test |
| رقم الانضمام: | edsair.doi...........37e86839d594c665f2af9a196879394c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
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