Applying a neoscore in locally advanced rectal cancer is beneficial in predicting local recurrences after surgery.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
08
10
2021
accepted:
01
05
2023
medline:
15
5
2023
pubmed:
12
5
2023
entrez:
12
5
2023
Statut:
epublish
Résumé
The current study was undertaken to provide more detailed prognostic models for early prediction of local recurrences and local recurrence free survival (RFS) using different radiologic and pathologic features of locally advanced rectal carcinomas treated with neoadjuvant chemoradiation (CRT). One hundred patients with locally advanced rectal carcinomas decided to receive neoadjuvant CRT were retrospectively recruited, Hazard ratios (HR) were determined in the two cox regression models and only significant ratios were considered for pointing, Models were built to determine their important effects of different predictors including: pathologic T (T), pathologic N (N), grade (G), clinical stage (cTNM), site (S), perineural invasion (PNI), and response to CRT (R) on 3-year RFS, goodness of performance of each model was measured by Harrell's C index. HR of 1st group of models: T+N, T+N+G, T+N+G+S, T+N+G+S+PNI, and T+N+G+S+PNI+R were summated and categorized into scores, these scores were significantly correlated with the risk of recurrence (Somer's D = 0.5, p<0.0001) & Harrell's C index = 0.751, (Somer's D = 0.6, p<0.0001) & its Harrell's C index = 0.794, (Somer's D = 0.7, p<0.0001) & C index = 0.826, Somer's D = 0.7, p<0.0001) & C index = 0.827, and (Somer's D = 0.7, p<0.0001) & C index = 0.843 respectively. The 2nd group of models including: cTNM stage, cTNM+G, cTNM+G+S, cTNM+G+S+PNI, cTNM+G+S+PNI+R scores which were significantly correlated with the HR of LRR (Somer's D = 0.2, 0.5, 0.6, 0.6, & 0.6 respectively), (p = 0.006, <0.0001, <0.0001, <0.0001, <0.0001 respectively), the corresponding Harrell's C indices were 0.595, 0.743, 0.782, 0.795, & 0.813 respectively. We propose that the addition of biologic factors to staging of rectal cancer provide precise stratification and association with local recurrences in patients received preoperative CRT.
Sections du résumé
BACKGROUND AND AIM
The current study was undertaken to provide more detailed prognostic models for early prediction of local recurrences and local recurrence free survival (RFS) using different radiologic and pathologic features of locally advanced rectal carcinomas treated with neoadjuvant chemoradiation (CRT).
METHODS
One hundred patients with locally advanced rectal carcinomas decided to receive neoadjuvant CRT were retrospectively recruited, Hazard ratios (HR) were determined in the two cox regression models and only significant ratios were considered for pointing, Models were built to determine their important effects of different predictors including: pathologic T (T), pathologic N (N), grade (G), clinical stage (cTNM), site (S), perineural invasion (PNI), and response to CRT (R) on 3-year RFS, goodness of performance of each model was measured by Harrell's C index.
RESULTS
HR of 1st group of models: T+N, T+N+G, T+N+G+S, T+N+G+S+PNI, and T+N+G+S+PNI+R were summated and categorized into scores, these scores were significantly correlated with the risk of recurrence (Somer's D = 0.5, p<0.0001) & Harrell's C index = 0.751, (Somer's D = 0.6, p<0.0001) & its Harrell's C index = 0.794, (Somer's D = 0.7, p<0.0001) & C index = 0.826, Somer's D = 0.7, p<0.0001) & C index = 0.827, and (Somer's D = 0.7, p<0.0001) & C index = 0.843 respectively. The 2nd group of models including: cTNM stage, cTNM+G, cTNM+G+S, cTNM+G+S+PNI, cTNM+G+S+PNI+R scores which were significantly correlated with the HR of LRR (Somer's D = 0.2, 0.5, 0.6, 0.6, & 0.6 respectively), (p = 0.006, <0.0001, <0.0001, <0.0001, <0.0001 respectively), the corresponding Harrell's C indices were 0.595, 0.743, 0.782, 0.795, & 0.813 respectively.
CONCLUSION
We propose that the addition of biologic factors to staging of rectal cancer provide precise stratification and association with local recurrences in patients received preoperative CRT.
Identifiants
pubmed: 37172066
doi: 10.1371/journal.pone.0285709
pii: PONE-D-21-32360
pmc: PMC10180662
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0285709Informations de copyright
Copyright: © 2023 Rayan, Soliman. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
the authors have declared that no competing interests exist.
Références
N Engl J Med. 2004 Oct 21;351(17):1731-40
pubmed: 15496622
Cancer. 1995 May 1;75(9):2269-75
pubmed: 7712435
Ann Oncol. 2008 Sep;19 Suppl 7:vii266-72
pubmed: 18790964
Am J Clin Oncol. 2001 Apr;24(2):107-12
pubmed: 11319280
JAMA. 1982 May 14;247(18):2543-6
pubmed: 7069920
J Natl Cancer Inst. 2014 Sep 22;106(10):
pubmed: 25249541
World J Gastroenterol. 2014 Nov 7;20(41):15049-59
pubmed: 25386053
Eur J Surg Oncol. 1999 Aug;25(4):368-74
pubmed: 10419706
Ann Surg Oncol. 2017 Nov;24(12):3502-3509
pubmed: 28726077
J Gastrointest Oncol. 2016 Aug;7(4):603-8
pubmed: 27563451
J Clin Oncol. 2011 Dec 10;29(35):4654-61
pubmed: 22084362
CA Cancer J Clin. 2017 Mar;67(2):93-99
pubmed: 28094848
N Engl J Med. 2001 Aug 30;345(9):638-46
pubmed: 11547717
Int J Biol Sci. 2016 Jul 17;12(8):1022-31
pubmed: 27489505
Acta Oncol. 2008;47(1):20-31
pubmed: 17957502
J Clin Pathol. 2006 May;59(5):505-12
pubmed: 16522747
JAMA Oncol. 2016 Jul 1;2(7):929-36
pubmed: 26986538
Radiat Oncol J. 2017 Sep;35(3):198-207
pubmed: 29037017
Prz Gastroenterol. 2019;14(2):89-103
pubmed: 31616522
CA Cancer J Clin. 2017 May 6;67(3):177-193
pubmed: 28248415
Ann Surg Oncol. 2007 Oct;14(10):2766-72
pubmed: 17551794
N Engl J Med. 1997 Apr 3;336(14):980-7
pubmed: 9091798
Lancet. 1996 Dec 14;348(9042):1605-10
pubmed: 8961989
Cancer. 1990 Dec 1;66(11):2286-94
pubmed: 2245382
Dis Colon Rectum. 2017 Jul;60(7):697-705
pubmed: 28594719
J Natl Cancer Inst. 1988 Mar 2;80(1):21-9
pubmed: 3276900
Br J Surg. 2012 Jul;99(7):918-28
pubmed: 22362002
Radiother Oncol. 2009 Aug;92(2):148-63
pubmed: 19595467