The significance of extramural venous invasion in R1 positive rectal cancer
Background and aims Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer. Mater...
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| Veröffentlicht in: | International journal of colorectal disease 2017, Vol.32 (1), p.119-124 |
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| container_title | International journal of colorectal disease |
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| creator | Ormsby, N. M. Bermingham, H. N. Joshi, H. M. Chadwick, M. Samad, A. Maitra, D. Scott, M. Kelly, S. Whitmarsh, K. Rajaganeshan, R. |
| description | Background and aims
Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer.
Material and methods
Retrospective study of all patients operatively managed within our institution between April 2008 and April 2013 for rectal cancer. Baseline demographics and multiple outcome measures recorded. Overall survival (OS), disease-free survival (DFS) and recurrence were the primary outcome measures.
Results
Overall, there were 306 primary rectal cancers. Seventy-six percent were grade T3/4 tumours. OS was 30 months. R1 rate was 16 % (48 patients). Thirty-one patients underwent APR and 17 AR. In patients who responded to neoadjuvant chemotherapy (NAC), overall survival was 55 months, with no extramural venous invasion (EMV) seen in this cohort. In non-responders OS was 29 months, with EMV in 48 %. In patients who did not receive NAC, OS was 23 months, with EMV in 74 %. EMV is a strong predictor for poor survival following R1 (
p
= 0.001). We also found a correlation between number of positive nodes and OS/DFS (
p
= 0.004).
Conclusions
In this small cohort of patients with R1 positive rectal cancers, response to NAC is the strongest predictor of poor overall and disease-free survival. In patients who respond to NAC, OS and DFS has been shown to be positive, with a reduced rate of EMV. |
| doi_str_mv | 10.1007/s00384-016-2658-7 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859484632</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714488890</galeid><sourcerecordid>A714488890</sourcerecordid><originalsourceid>FETCH-LOGICAL-c472t-cbd66df938e430e87d9602cad0951ccad8d064bf04d231139ff776ee4711871a3</originalsourceid><addsrcrecordid>eNqNkUuLFDEUhYMoTjv6A9xIgRs3NeYmqTyWw6CjOCDIuA7p1E2boSrVJlWN_ntT0-MTBcni5vGdw705hDwFegaUqpeFUq5FS0G2THa6VffIBgRnLTDJ7pMNBWVaMJ0-IY9KuaH1LJV4SE6YkqYznG3Iu-tP2JS4SzFE75LHZgoNfpmzG5fshuaAaVpKE9PBlTilumk-QLOfSpzjAZuMfq7UrTI_Jg-CGwo-uaun5OPrV9cXb9qr95dvL86vWi8Um1u_7aXsg-EaBaeoVW8kZd711HTga9U9lWIbqOgZB-AmBKUkolAAWoHjp-TF0Xefp88LltmOsXgcBpewNmtBd0ZoITn7D5R3vH4EUxV9_gd6My051UFWQ8mgGnY_qZ0b0MYUpvpVfjW15wqE0FobWqmzv1B19ThGPyUMsd7_JoCjwOeplIzB7nMcXf5qgdo1a3vM2tas7Zq1XRt-dtfwsh2x_6H4Hm4F2BEo9SntMP8y0T9dvwGTCrDu</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1856214635</pqid></control><display><type>article</type><title>The significance of extramural venous invasion in R1 positive rectal cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Ormsby, N. M. ; Bermingham, H. N. ; Joshi, H. M. ; Chadwick, M. ; Samad, A. ; Maitra, D. ; Scott, M. ; Kelly, S. ; Whitmarsh, K. ; Rajaganeshan, R.</creator><creatorcontrib>Ormsby, N. M. ; Bermingham, H. N. ; Joshi, H. M. ; Chadwick, M. ; Samad, A. ; Maitra, D. ; Scott, M. ; Kelly, S. ; Whitmarsh, K. ; Rajaganeshan, R.</creatorcontrib><description>Background and aims
Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer.
Material and methods
Retrospective study of all patients operatively managed within our institution between April 2008 and April 2013 for rectal cancer. Baseline demographics and multiple outcome measures recorded. Overall survival (OS), disease-free survival (DFS) and recurrence were the primary outcome measures.
Results
Overall, there were 306 primary rectal cancers. Seventy-six percent were grade T3/4 tumours. OS was 30 months. R1 rate was 16 % (48 patients). Thirty-one patients underwent APR and 17 AR. In patients who responded to neoadjuvant chemotherapy (NAC), overall survival was 55 months, with no extramural venous invasion (EMV) seen in this cohort. In non-responders OS was 29 months, with EMV in 48 %. In patients who did not receive NAC, OS was 23 months, with EMV in 74 %. EMV is a strong predictor for poor survival following R1 (
p
= 0.001). We also found a correlation between number of positive nodes and OS/DFS (
p
= 0.004).
Conclusions
In this small cohort of patients with R1 positive rectal cancers, response to NAC is the strongest predictor of poor overall and disease-free survival. In patients who respond to NAC, OS and DFS has been shown to be positive, with a reduced rate of EMV.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-016-2658-7</identifier><identifier>PMID: 27695932</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adjuvant treatment ; Cancer ; Colorectal cancer ; Disease-Free Survival ; Gastroenterology ; Hepatology ; Humans ; Internal Medicine ; Kaplan-Meier Estimate ; Lymph Nodes - pathology ; Margins of Excision ; Medicine ; Medicine & Public Health ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - pathology ; Oncology, Experimental ; Original Article ; Proctology ; Prognosis ; Rectal Neoplasms - drug therapy ; Rectal Neoplasms - pathology ; Rectal Neoplasms - surgery ; Surgery ; Veins - pathology</subject><ispartof>International journal of colorectal disease, 2017, Vol.32 (1), p.119-124</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>COPYRIGHT 2017 Springer</rights><rights>International Journal of Colorectal Disease is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-cbd66df938e430e87d9602cad0951ccad8d064bf04d231139ff776ee4711871a3</citedby><cites>FETCH-LOGICAL-c472t-cbd66df938e430e87d9602cad0951ccad8d064bf04d231139ff776ee4711871a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-016-2658-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-016-2658-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27695932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ormsby, N. M.</creatorcontrib><creatorcontrib>Bermingham, H. N.</creatorcontrib><creatorcontrib>Joshi, H. M.</creatorcontrib><creatorcontrib>Chadwick, M.</creatorcontrib><creatorcontrib>Samad, A.</creatorcontrib><creatorcontrib>Maitra, D.</creatorcontrib><creatorcontrib>Scott, M.</creatorcontrib><creatorcontrib>Kelly, S.</creatorcontrib><creatorcontrib>Whitmarsh, K.</creatorcontrib><creatorcontrib>Rajaganeshan, R.</creatorcontrib><title>The significance of extramural venous invasion in R1 positive rectal cancer</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Background and aims
Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer.
Material and methods
Retrospective study of all patients operatively managed within our institution between April 2008 and April 2013 for rectal cancer. Baseline demographics and multiple outcome measures recorded. Overall survival (OS), disease-free survival (DFS) and recurrence were the primary outcome measures.
Results
Overall, there were 306 primary rectal cancers. Seventy-six percent were grade T3/4 tumours. OS was 30 months. R1 rate was 16 % (48 patients). Thirty-one patients underwent APR and 17 AR. In patients who responded to neoadjuvant chemotherapy (NAC), overall survival was 55 months, with no extramural venous invasion (EMV) seen in this cohort. In non-responders OS was 29 months, with EMV in 48 %. In patients who did not receive NAC, OS was 23 months, with EMV in 74 %. EMV is a strong predictor for poor survival following R1 (
p
= 0.001). We also found a correlation between number of positive nodes and OS/DFS (
p
= 0.004).
Conclusions
In this small cohort of patients with R1 positive rectal cancers, response to NAC is the strongest predictor of poor overall and disease-free survival. In patients who respond to NAC, OS and DFS has been shown to be positive, with a reduced rate of EMV.</description><subject>Adjuvant treatment</subject><subject>Cancer</subject><subject>Colorectal cancer</subject><subject>Disease-Free Survival</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymph Nodes - pathology</subject><subject>Margins of Excision</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Prognosis</subject><subject>Rectal Neoplasms - drug therapy</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Surgery</subject><subject>Veins - pathology</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUuLFDEUhYMoTjv6A9xIgRs3NeYmqTyWw6CjOCDIuA7p1E2boSrVJlWN_ntT0-MTBcni5vGdw705hDwFegaUqpeFUq5FS0G2THa6VffIBgRnLTDJ7pMNBWVaMJ0-IY9KuaH1LJV4SE6YkqYznG3Iu-tP2JS4SzFE75LHZgoNfpmzG5fshuaAaVpKE9PBlTilumk-QLOfSpzjAZuMfq7UrTI_Jg-CGwo-uaun5OPrV9cXb9qr95dvL86vWi8Um1u_7aXsg-EaBaeoVW8kZd711HTga9U9lWIbqOgZB-AmBKUkolAAWoHjp-TF0Xefp88LltmOsXgcBpewNmtBd0ZoITn7D5R3vH4EUxV9_gd6My051UFWQ8mgGnY_qZ0b0MYUpvpVfjW15wqE0FobWqmzv1B19ThGPyUMsd7_JoCjwOeplIzB7nMcXf5qgdo1a3vM2tas7Zq1XRt-dtfwsh2x_6H4Hm4F2BEo9SntMP8y0T9dvwGTCrDu</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Ormsby, N. M.</creator><creator>Bermingham, H. N.</creator><creator>Joshi, H. M.</creator><creator>Chadwick, M.</creator><creator>Samad, A.</creator><creator>Maitra, D.</creator><creator>Scott, M.</creator><creator>Kelly, S.</creator><creator>Whitmarsh, K.</creator><creator>Rajaganeshan, R.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>2017</creationdate><title>The significance of extramural venous invasion in R1 positive rectal cancer</title><author>Ormsby, N. M. ; Bermingham, H. N. ; Joshi, H. M. ; Chadwick, M. ; Samad, A. ; Maitra, D. ; Scott, M. ; Kelly, S. ; Whitmarsh, K. ; Rajaganeshan, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-cbd66df938e430e87d9602cad0951ccad8d064bf04d231139ff776ee4711871a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adjuvant treatment</topic><topic>Cancer</topic><topic>Colorectal cancer</topic><topic>Disease-Free Survival</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymph Nodes - pathology</topic><topic>Margins of Excision</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Prognosis</topic><topic>Rectal Neoplasms - drug therapy</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Surgery</topic><topic>Veins - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ormsby, N. M.</creatorcontrib><creatorcontrib>Bermingham, H. N.</creatorcontrib><creatorcontrib>Joshi, H. M.</creatorcontrib><creatorcontrib>Chadwick, M.</creatorcontrib><creatorcontrib>Samad, A.</creatorcontrib><creatorcontrib>Maitra, D.</creatorcontrib><creatorcontrib>Scott, M.</creatorcontrib><creatorcontrib>Kelly, S.</creatorcontrib><creatorcontrib>Whitmarsh, K.</creatorcontrib><creatorcontrib>Rajaganeshan, R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ormsby, N. M.</au><au>Bermingham, H. N.</au><au>Joshi, H. M.</au><au>Chadwick, M.</au><au>Samad, A.</au><au>Maitra, D.</au><au>Scott, M.</au><au>Kelly, S.</au><au>Whitmarsh, K.</au><au>Rajaganeshan, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The significance of extramural venous invasion in R1 positive rectal cancer</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2017</date><risdate>2017</risdate><volume>32</volume><issue>1</issue><spage>119</spage><epage>124</epage><pages>119-124</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Background and aims
Evidence has shown that a positive resection margin (R1) is a key determinant of subsequent local recurrence and a poor prognostic factor in rectal cancer. The aim of this study was to evaluate the outcomes and prognosticators in patients with R1 resection of rectal cancer.
Material and methods
Retrospective study of all patients operatively managed within our institution between April 2008 and April 2013 for rectal cancer. Baseline demographics and multiple outcome measures recorded. Overall survival (OS), disease-free survival (DFS) and recurrence were the primary outcome measures.
Results
Overall, there were 306 primary rectal cancers. Seventy-six percent were grade T3/4 tumours. OS was 30 months. R1 rate was 16 % (48 patients). Thirty-one patients underwent APR and 17 AR. In patients who responded to neoadjuvant chemotherapy (NAC), overall survival was 55 months, with no extramural venous invasion (EMV) seen in this cohort. In non-responders OS was 29 months, with EMV in 48 %. In patients who did not receive NAC, OS was 23 months, with EMV in 74 %. EMV is a strong predictor for poor survival following R1 (
p
= 0.001). We also found a correlation between number of positive nodes and OS/DFS (
p
= 0.004).
Conclusions
In this small cohort of patients with R1 positive rectal cancers, response to NAC is the strongest predictor of poor overall and disease-free survival. In patients who respond to NAC, OS and DFS has been shown to be positive, with a reduced rate of EMV.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27695932</pmid><doi>10.1007/s00384-016-2658-7</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2017, Vol.32 (1), p.119-124 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1859484632 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adjuvant treatment Cancer Colorectal cancer Disease-Free Survival Gastroenterology Hepatology Humans Internal Medicine Kaplan-Meier Estimate Lymph Nodes - pathology Margins of Excision Medicine Medicine & Public Health Neoadjuvant Therapy Neoplasm Invasiveness Neoplasm Recurrence, Local - pathology Oncology, Experimental Original Article Proctology Prognosis Rectal Neoplasms - drug therapy Rectal Neoplasms - pathology Rectal Neoplasms - surgery Surgery Veins - pathology |
| title | The significance of extramural venous invasion in R1 positive rectal cancer |
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