Background

Few studies have compared the survival outcomes of stages II and IIIA rectal cancer patients who did not receive neoadjuvant treatment. This study aimed to compare oncologic outcomes between 2 groups.

Patients and Methods

This study analyzed stage II or IIIA rectal cancer patients who underwent radical operation without neoadjuvant treatment between 1996 and 2013. The 3:1 propensity score analysis was used to adjust for several variables. After propensity score matching, 364 stage II rectal cancer, and 172 stage IIIA rectal cancer patients were analyzed.

Results

There were no significant differences in 5-year overall survival or disease-free survival rates between the 2 groups. When stage II rectal cancer was subdivided into stages IIA, IIB, and IIC, the 5-year DFS and OS rates of stage IIIA rectal cancer patients were similar to those of stage IIA cancer patients. Moreover, stage IIIA rectal cancer patients showed a statistically significantly better survival rates than stage IIC rectal cancer patients.

Conclusion

Stage IIIA group showed similar survival outcomes compared to stage IIA and IIB group and significantly better outcomes than stage IIC group. Thus, it should be considered to classify stage IIIA as a subgroup of stage II rather than as a subgroup of stage III rectal cancer. It should be also be considered to change to determine whether to do adjuvant treatment according to stage II rectal cancer.

中文翻译：

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IIIA期直肠癌应重新考虑分期迁移：基于倾向评分分析

背景

很少有研究比较未接受新辅助治疗的 II 期和 IIIA 期直肠癌患者的生存结果。本研究旨在比较两组之间的肿瘤学结果。

患者和方法

本研究分析了 1996 年至 2013 年间在没有新辅助治疗的情况下接受根治性手术的 II 期或 IIIA 期直肠癌患者。使用 3:1 倾向评分分析来调整几个变量。在倾向评分匹配后，对 364 名 II 期直肠癌和 172 名 IIIA 期直肠癌患者进行了分析。

结果

两组之间的 5 年总生存率或无病生存率无显着差异。当II期直肠癌细分为IIA、IIB和IIC期时，IIIA期直肠癌患者的5年DFS和OS率与IIA期患者相似。此外，IIIA 期直肠癌患者的生存率在统计学上显着优于 IIC 期直肠癌患者。

结论

与 IIA 期和 IIB 组相比，IIIA 期组显示出相似的生存结果，并且显着优于 IIC 期组。因此，应考虑将 IIIA 期分类为 II 期的亚组，而不是 III 期直肠癌的亚组。也应考虑改变，根据Ⅱ期直肠癌确定是否做辅助治疗。