Please use this identifier to cite or link to this item: http://dx.doi.org/10.25673/118753
Title: Prognosis and quality of life in patients with locally advanced rectal cancer after abdominoperineal resection in the CAO/ARO/AIO-04 randomized phase 3 trial
Author(s): Gaedcke, Jochen Werner ChristianLook up in the Integrated Authority File of the German National Library
Sahrhage, MalteLook up in the Integrated Authority File of the German National Library
Ebeling, MarcelLook up in the Integrated Authority File of the German National Library
Azizian, Azadeh
Rühlmann, Felix
Bernhardt-Römermann, MarkusLook up in the Integrated Authority File of the German National Library
Grade, MarianLook up in the Integrated Authority File of the German National Library
Beschstein, Wolf Otto
Germer, Christoph-ThomasLook up in the Integrated Authority File of the German National Library
Grützmann, RobertLook up in the Integrated Authority File of the German National Library
Piso, Pompiliu IoanLook up in the Integrated Authority File of the German National Library
Hofheinz, Ralf-DieterLook up in the Integrated Authority File of the German National Library
Staib, Ludger
Beissbarth, TimLook up in the Integrated Authority File of the German National Library
Kosmala, RebekkaLook up in the Integrated Authority File of the German National Library
Fokas, EmmanouilLook up in the Integrated Authority File of the German National Library
Rödel, ClausLook up in the Integrated Authority File of the German National Library
Ghadimi, MichaelLook up in the Integrated Authority File of the German National Library
Issue Date: 2025
Type: Article
Language: English
Abstract: Low anterior resection (LAR) and abdominoperineal resection (APR) are the two main surgical procedures after preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer. APR is associated with poorer prognosis; however existing data do not consider intensified CRT (5-Fluorouracil (5-FU)/Oxaliplatin + radiation) protocols. Clinicopathological data of patients treated with APR and LAR from the CAO/ARO/AIO-04 trial were analysed in terms of prognostic parameters and quality of life (QoL). Based on higher response rate after intensified CRT, subgroup analyses were performed. Data from n = 1173 patients were assessed. APR after preoperative CRT was associated with a significantly worse overall survival (p = 0.0056), disease-free survival (p < 0.0001) and local recurrence rate (p = 0.0047). Clinicopathological data including clinical T stage (p < 0.000001), grading (p = 0.0038), postoperative lymph node (LN) positivity (p = 0.013), and number of positive LN (p = 0.0049) significantly differed between procedures and showed higher values in APR patients. The quality of total mesorectal excision (TME) was significantly better (p < 0.0001) and complete resection rates were higher (p = 0.0022) in LAR compared to APR patients. Subgroup analyses showed worse LR rates in APR patients after standard CRT (5-FU mono and radiation) but not after intensified CRT. After 3 years, role functioning (p = 0.019) and physical functioning (p = 0.001) had a slightly poorer outcome in APR patients. The poorer prognosis of patients undergoing APR for locally advanced rectal cancer may be explained by clinicopathological characteristics. Intensified CRT may compensate for the higher risk of LR after APR in patients with worse TME quality. QoL in APR patients was comparable to LAR patients.
URI: https://opendata.uni-halle.de//handle/1981185920/120711
http://dx.doi.org/10.25673/118753
Open Access: Open access publication
License: (CC BY-NC-ND 4.0) Creative Commons Attribution NonCommercial NoDerivatives 4.0(CC BY-NC-ND 4.0) Creative Commons Attribution NonCommercial NoDerivatives 4.0
Journal Title: Scientific reports
Publisher: Springer Nature
Publisher Place: [London]
Volume: 15
Original Publication: 10.1038/s41598-024-83105-z
Appears in Collections:Open Access Publikationen der MLU

Files in This Item:
File Description SizeFormat 
s41598-024-83105-z.pdf1.79 MBAdobe PDFThumbnail
View/Open