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Impact of Postoperative Chemoradiotherapy versus Chemotherapy Alone on Recurrence and Survival in Patients with Stage II and III Upper Rectal Cancer: A Propensity Score-Matched Analysis

Publication Date: April 22, 2015
Journal: PLOS ONE
Authors: Changhoon Song, Sanghyuk Song, Jae Sung Kim, Heung Kwon Oh, et al
Volume: 10
Issue: 4
Pages: e0123657
DOI: https://dx.plos.org/10.1371/journal.pone.0123657
Publisher URL: http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0123657
PubMed: http://www.ncbi.nlm.nih.gov/pubmed/25902069
PubMed Central: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406553
Europe PMC: http://europepmc.org/abstract/MED/25902069
Scopus: 84930678947
Mendeley: http://www.mendeley.com/research/impact-postoperative-chemoradiotherapy-versus-chemotherapy-alone-recurrence-survival-patients-stage-2

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CiteULike28 Apr 09:11 UTC

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Mendeley 625 Apr 03:08 UTC

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ORCID23 Apr 04:03 UTC

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Web of Science®14 Apr 07:04 UTC

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Journal Comments24 Oct 13:02 UTC

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Figshare 12227 Apr 23:22 UTC

Figshare

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{"files"=>["https://ndownloader.figshare.com/files/2035337", "https://ndownloader.figshare.com/files/2035338"], "description"=>"<div>PurposeTo compare the impact of postoperative chemoradiotherapy (CRT) versus adjuvant chemotherapy alone on recurrence and survival in patients with stage II and III upper rectal cancer undergoing curative resection.Materials and MethodsFrom our institutional database, 190 patients who underwent primary curative resection between 2003 and 2010 for stage II or III upper rectal cancer were identified. None of the patients received preoperative CRT. Of these, 136 patients received postoperative chemotherapy alone (the CTx group) and 54 patients received postoperative CRT (the CRT group). The CRT group had poorer prognostic features (pT4, pN2, poor differentiation, or involved resection margin) compared with the CTx group. To reduce the impact of treatment selection bias on treatment outcomes, propensity score-matching analysis was used.ResultsThe matched cohort consisted of 50 CRT and 50 CTx patients with a median follow-up period of 76 and 63 months, respectively. In the matched cohort, CRT resulted in an improved 5-year local control (98.0% vs. 85.2%, p = 0.024) and overall survival rate (89.9% vs. 69.8%, p = 0.021) compared with CTx. In the subgroup analysis to identify subpopulations of patients that benefit most from receiving CRT, local recurrence did not occur in patients who did not have poor prognostic features regardless of the receipt of CRT. For patients with any poor prognostic features, CRT resulted in an improved 5-year local control compared with CTx (96.4% vs. 70.7%, p = 0.013).ConclusionsAfter adjusting for clinicopathologic factors by propensity score-matching, postoperative CRT was associated with improved local control and overall survival in stage II and III upper rectal cancer. Our results suggest that surgery followed by chemotherapy alone is acceptable for patients who did not have poor prognostic features, while additional radiotherapy should be given for patients who have any poor prognostic features.</div>", "links"=>[], "tags"=>["postoperative CRT", "Rectal cancer", "stage II", "prognostic features", "CRT group", "50 CTx patients", "CTx group", "treatment selection bias", "III Upper Rectal Cancer"], "article_id"=>1391055, "categories"=>["Uncategorised"], "users"=>["Changhoon Song", "Sanghyuk Song", "Jae-Sung Kim", "Heung-Kwon Oh", "Duck-Woo Kim", "Keun-Wook Lee", "Jee Hyun Kim", "Keun-Yong Eom", "In Ah Kim", "Sung-Bum Kang"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0123657.s001", "https://dx.doi.org/10.1371/journal.pone.0123657.s002"], "stats"=>{"downloads"=>12, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Impact_of_Postoperative_Chemoradiotherapy_versus_Chemotherapy_Alone_on_Recurrence_and_Survival_in_Patients_with_Stage_II_and_III_Upper_Rectal_Cancer_A_Propensity_Score_Matched_Analysis_/1391055", "title"=>"Impact of Postoperative Chemoradiotherapy versus Chemotherapy Alone on Recurrence and Survival in Patients with Stage II and III Upper Rectal Cancer: A Propensity Score-Matched Analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-04-22 03:20:25"}

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{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}

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