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Background <p>To identify tumor size could be taken as a decision-making factor in the management of preoperative radiotherapy (RT) for patients with locally advanced rectal cancer (LARC).</p> Methods <p>In this study, patients diagnosed with rectal adenocarcinoma and staged at II/III from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2014 were included. Kaplan-Meier curve was conducted to investigate the overall survival (OS) between subgroups with different tumor sizes and the relationship between the tumor size and the efficacy of preoperative RT.</p> Results <p>There were 1402 patients eligible for this study, of whom 1105 (78.8%) received preoperative radiotherapy (RT + S group) and 297 (21.2%) underwent surgery alone (S group). The median OS was comparable between groups of RT + S and S before and after propensity score matching (both <i>P</i> &gt; 0.05), but tumor size was a robust independent risk factor of OS (<i>P</i> &lt; 0.05). 5&#xa0;cm was then identified to the optimal cut-off value of tumor size using the minimum P value. Further analysis showed that preoperative RT could only benefit those with tumor size &gt; 5&#xa0;cm (<i>P</i> &lt; 0.05); while on the contrary, it would hamper the OS of those with tumor size ≤ 5&#xa0;cm and no OS risk factors (<i>P</i> &gt; 0.05).</p> Conclusion <p>Data from this retrospective analysis of patients with LARC seems to indicate that tumor size might play a role in the decision-making process for (tumors &gt; 5&#xa0;cm) or against (tumors ≤ 5&#xa0;cm) preoperative radiotherapy.</p>

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Tumor size in the management of preoperative radiotherapy for locally advanced rectal cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月29日

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  • Xiaohong Zhong,
  • Huaqin Lin,
  • Qizhen Huang,
  • Lei Wang,
  • Junxin Wu

摘要

Background

To identify tumor size could be taken as a decision-making factor in the management of preoperative radiotherapy (RT) for patients with locally advanced rectal cancer (LARC).

Methods

In this study, patients diagnosed with rectal adenocarcinoma and staged at II/III from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2014 were included. Kaplan-Meier curve was conducted to investigate the overall survival (OS) between subgroups with different tumor sizes and the relationship between the tumor size and the efficacy of preoperative RT.

Results

There were 1402 patients eligible for this study, of whom 1105 (78.8%) received preoperative radiotherapy (RT + S group) and 297 (21.2%) underwent surgery alone (S group). The median OS was comparable between groups of RT + S and S before and after propensity score matching (both P > 0.05), but tumor size was a robust independent risk factor of OS (P < 0.05). 5 cm was then identified to the optimal cut-off value of tumor size using the minimum P value. Further analysis showed that preoperative RT could only benefit those with tumor size > 5 cm (P < 0.05); while on the contrary, it would hamper the OS of those with tumor size ≤ 5 cm and no OS risk factors (P > 0.05).

Conclusion

Data from this retrospective analysis of patients with LARC seems to indicate that tumor size might play a role in the decision-making process for (tumors > 5 cm) or against (tumors ≤ 5 cm) preoperative radiotherapy.