Browse > Article
http://dx.doi.org/10.3857/roj.2017.00332

Prognostic significance of adjuvant radiation therapy in adenocarcinoma of the cecum  

Hosseini, Sare (Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences)
Bananzadeh, Ali Mohammad (Colorectal Research Center, Department of Radiation Oncology, Shiraz University of Medical Sciences)
Mohammadianpanah, Mohammad (Colorectal Research Center, Department of Radiation Oncology, Shiraz University of Medical Sciences)
Salek, Roham (Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences)
Taghizadeh-Kermani, Ali (Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences)
Publication Information
Radiation Oncology Journal / v.36, no.1, 2018 , pp. 45-53 More about this Journal
Abstract
Purpose: Local recurrence is a common failure pattern in adenocarcinoma of the cecum. This study aimed to investigate the potential role of adjuvant radiation therapy on oncologic outcomes of patients with adenocarcinoma of the cecum. Materials and Methods: This retrospective study was carried out at three large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of 162 patients with adenocarcinoma of the cecum that were treated and followed up between 2000 and 2013. All the patients had undergone a right hemicolectomy and received chemotherapy with (n = 48) or without (n = 114) adjuvant radiation therapy. Results: The subjects were 65 females and 97 males with a median age of 56 years (range, 17 to 90 years) at diagnosis. The 5-year local control (LC), disease free survival (DFS), and overall survival (OS) rates were 72.7%, 57.2%, and 62.6% respectively. In a multivariate analysis, age, tumor stage, node stage, and adjuvant radiation therapy were determined to be independent prognostic factors. Age more than 55 years (hazard ratio [HR] = 1.0; 95% confidence interval [CI], 0.06-0.32; p = 0.003), T4 stage (HR = 6.8; 95% CI, 3.07-15.36; p < 0.001), node positive disease (HR = 4.2; 95% CI, 1.94-9.13; p < 0.001), and the absence of adjuvant radiation therapy (HR = 3.0; 95% CI, 1.39-6.46; p = 0.005) had a negative influence on OS. Conclusion: Adjuvant radiation therapy significantly improves DFS and OS in patients with adenocarcinoma of the cecum.
Keywords
Adenocarcinoma; Cecum; Colon; Adjuvant radiation therapy; Prognosis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86.   DOI
2 Haenszel W, Correa P. Cancer of the large intestine: epidemiologic findings. Dis Colon Rectum 1973;16:371-7.   DOI
3 Iacopetta B. Are there two sides to colorectal cancer? Int J Cancer 200;101:403-8.   DOI
4 Tong D, Russell AH, Dawson LE, et al. Adenocarcinoma of the cecum: natural history and clinical patterns of recurrence following radical surgery. Int J Radiat Oncol Biol Phys 1983;9:357-60.   DOI
5 Willett C, Tepper JE, Cohen A, Orlow E, Welch C, Donaldson G. Local failure following curative resection of colonic adenocarcinoma. Int J Radiat Oncol Biol Phys 1984;10:645-51.   DOI
6 Mendenhall WM, Rout WR, Lind DS, et al. Role of radiation therapy in the treatment of resectable rectal adenocarcinoma. J Surg Oncol 2002;79:107-17.   DOI
7 Mendenhall WM, Zlotecki RA, Snead FE, et al. Radiotherapy in the treatment of resectable rectal adenocarcinoma. Am J Clin Oncol 2009;32:629-38.   DOI
8 Kavanagh BD, Pan CC, Dawson LA, et al. Radiation dosevolume effects in the stomach and small bowel. Int J Radiat Oncol Biol Phys 2010;76(3 Suppl):S101-7.   DOI
9 Shehata WM, Meyer RL, Jazy FK, Cormier WJ, Welling RE. Regional adjuvant irradiation for adenocarcinoma of the cecum. Int J Radiat Oncol Biol Phys 1987;13:843-6.   DOI
10 Kopelson G. Adjuvant postoperative radiation therapy for colorectal carcinoma above the peritoneal reflection. II. Antimesenteric wall ascending and descending colon and cecum. Cancer 1983;52:633-6.   DOI
11 Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17:1471-4.   DOI
12 Cai B, Wang MY, Liao K, et al. Distribution characteristics of 3,369 Chinese colorectal cancer patients for gender, age, location and tumor size during colonoscopy. Asian Pac J Cancer Prev 2014;15:8951-5.   DOI
13 Gonzalez EC, Roetzheim RG, Ferrante JM, Campbell R. Predictors of proximal vs. distal colorectal cancers. Dis Colon Rectum 2001;44:251-8.   DOI
14 Slattery ML, Friedman GD, Potter JD, Edwards S, Caan BJ, Samowitz W. A description of age, sex, and site distributions of colon carcinoma in three geographic areas. Cancer 1996;78:1666-70.   DOI
15 Nelson RL, Dollear T, Freels S, Persky V. The relation of age, race, and gender to the subsite location of colorectal carcinoma. Cancer 1997;80:193-7.   DOI
16 Nawa T, Kato J, Kawamoto H, et al. Differences between right- and left-sided colon cancer in patient characteristics, cancer morphology and histology. J Gastroenterol Hepatol 2008;23:418-23.   DOI
17 Wong CS, Harwood AR, Cummings BJ, Keane TJ, Thomas GM, Rider WD. Postoperative local abdominal irradiation for cancer of the colon above the peritoneal reflection. Int J Radiat Oncol Biol Phys 1985;11:2067-71.   DOI
18 Willett CG, Fung CY, Kaufman DS, Efird J, Shellito PC. Postoperative radiation therapy for high-risk colon carcinoma. J Clin Oncol 1993;11:1112-7.   DOI
19 Amos EH, Mendenhall WM, McCarty PJ, et al. Postoperative radiotherapy for locally advanced colon cancer. Ann Surg Oncol 1996;3:431-6.   DOI
20 Niloofar A, Mosalaei A, Shapour O, Mohammadianpanah M. Role of external irradiation in high-risk resected colon cancer. Indian J Cancer 2005;42:133-7.   DOI
21 Fabian C, Giri S, Estes N, et al. Adjuvant continuous infusion 5-FU, whole-abdominal radiation, and tumor bed boost in high-risk stage III colon carcinoma: a Southwest Oncology Group Pilot study. Int J Radiat Oncol Biol Phys 1995;32:457-64.   DOI
22 Martenson JA Jr, Willett CG, Sargent DJ, et al. Phase III study of adjuvant chemotherapy and radiation therapy compared with chemotherapy alone in the surgical adjuvant treatment of colon cancer: results of Intergroup protocol 0130. J Clin Oncol 2004;22:3277-83.   DOI
23 Ben-Josef E, Court WS. Whole abdominal radiotherapy and concomitant 5-fluorouracil as adjuvant therapy in advanced colon cancer. Dis Colon Rectum 1995;38:1088-92.   DOI
24 Wong CS, Harwood AR, Cummings BJ, Keane TJ, Thomas GM, Rider WD. Total abdominal irradiation for cancer of the colon. Radiother Oncol 1984;2:209-14.   DOI
25 Kuebler JP, Wieand HS, O'Connell MJ, et al. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol 2007;25:2198-204.   DOI
26 Andre T, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 2009;27:3109-16.   DOI
27 Ludmir EB, Arya R, Wu Y, Palta M, Willett CG, Czito BG. Role of adjuvant radiotherapy in locally advanced colonic carcinoma in the modern chemotherapy era. Ann Surg Oncol 2016;23:856-62.   DOI