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Preoperative Radiotherapy Decision-Tree for Rectal Cancer Patients: A Real-World Analysis Based on the Swedish Colorectal Cancer Registry

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机构: [1]Department of Gastrointestinal Surgery, Sichuan Academy of Medical Science andSichuan Provincial People’s Hospital, School of Medicine, University of ElectronicScience and Technology of China, Chengdu, China [2]Department of Oncology and Department of Biomedical and Clinical Science,Linköping University, Linköping, Sweden [3]Department of Gastrointestinal, Bariatric, and Metabolic Surgery, Research Centerfor Nutrition, Metabolism and Food Safety, West China-PUMC C.C. Chen Instituteof Health, West China School of Public Health and West China Fourth Hospital,Sichuan University, Chengdu, China [4]Department of Biomedical and Clinical Sciences, Division of Surgery, LinköpingUniversity, Linköping, Sweden
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关键词: Survival Age Clinical stage Real-world data

摘要:
There are 3 widely used preoperative radiotherapy (RT) procedures in rectal cancer treatment including long-course RT (LRT), short-course RT with delayed surgery (SRTW), and short-course RT with immediate surgery (SRT). However, further evidence is required to determine which treatment option results in more optimal patient survival.This Swedish Colorectal Cancer Registry-based retrospective study of real-world data included 7766 stage I-III rectal cancer patients, of which 2982, 1089, 763, and 2932 patients received no RT (NRT), LRT, SRTW, and SRT, respectively. The Kaplan-Meier survival curve and Cox proportional hazard multivariate model were used to identify potential risk factors and to examine the independent association of RT with patient survival after adjusting for baseline confounding factors.RT effects on survival differed by age and clinical T stage (cT) subgroups. Subsequent survival analysis by age and cT subgroups confirmed that patients ≥70 years old with cT4 benefited from any RT (P < .001, NRT as reference) and equally from any RT (P > .05 pairwise between RTs). In contrast, for cT3 patients ≥70 years, SRT and LRT were associated with better survival than SRTW (P < .001). In patients <70 years, LRT and SRTW had superior survival benefits in cT4 patients but inferior to SRT (P < .001); SRT was the only effective treatment in the cT3N+ subgroup (P = .032); patients with cT3N0 and <70 years did not benefit from any RT.This study suggests that preoperative RT strategies may have varying effects on the survival of rectal cancer patients, depending on their age and clinical stage.Copyright © 2023 Elsevier Inc. All rights reserved.

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出版当年[2023]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
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出版当年[2023]版:
Q2 ONCOLOGY
最新[2023]版:
Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

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第一作者机构: [1]Department of Gastrointestinal Surgery, Sichuan Academy of Medical Science andSichuan Provincial People’s Hospital, School of Medicine, University of ElectronicScience and Technology of China, Chengdu, China [2]Department of Oncology and Department of Biomedical and Clinical Science,Linköping University, Linköping, Sweden [*1]Department of Gastrointestinal Surgery, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32th of West 2nd Section of 1st Ring Road, 610072, Chengdu, China.
通讯作者:
通讯机构: [1]Department of Gastrointestinal Surgery, Sichuan Academy of Medical Science andSichuan Provincial People’s Hospital, School of Medicine, University of ElectronicScience and Technology of China, Chengdu, China [2]Department of Oncology and Department of Biomedical and Clinical Science,Linköping University, Linköping, Sweden [*1]Department of Gastrointestinal Surgery, Sichuan Academy of Medical Science and Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, No. 32th of West 2nd Section of 1st Ring Road, 610072, Chengdu, China. [*2]Department of Oncology and Department of Biomedical and Clinical Science, Linköping University, Ingång 34, Sjukhusvägen, SE-581 83, Linköping, Sweden.
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