title: Identification of locally advanced rectal cancer with low risk of local recurrence.
abstract: BACKGROUND
  The routine application of neoadjuvant chemoradiotherapy for T3N0 rectal cancer remains controversial. The aim of this study was to use clinical, Magnetic resonance imaging, and pathological parameters to identify a subgroup of patients with low risk of local recurrence who might be precluded from neoadjuvant chemoradiotherapy.
  
  
  METHODS
  We retrospectively reviewed a prospectively maintained database of consecutive rectal cancer patients who underwent curative resection. 166 pathologic confirmed T3N0 rectal cancer patients with tumor located 5-12 cm above the anal verge and preoperative circumferential resection margin >1 mm were included in analysis. The primary outcomes measured were 3- and 5-year local recurrence rates.
  
  
  RESULTS
  Local recurrence was demonstrated during follow-up in 5 patients; the actuarial overall 3- and 5-year local recurrence rates were 2.5% and 3.4%, respectively. Inadequate sampling of lymph nodes (≤12) was associated with higher local recurrence (P = 0.03) in this group of patients.
  
  
  CONCLUSIONS
  For upper and middle T3N0 rectal cancer with preoperative circumferential resection margin >1 mm, local recurrence rate after total mesorectal excision is low and surgery alone may be enough for this group of patients.
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Qiao-Xuan
authors: QX
authors: Wang
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Shao-Hua
authors: SH
authors: Li
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Xu
authors: X
authors: Zhang
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Anesthesiology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Lan
authors: L
authors: Xie
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Medical Imaging & Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Pei-Qiang
authors: PQ
authors: Cai
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Xin
authors: X
authors: An
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Zhi-Zhong
authors: ZZ
authors: Pan
authors: State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, P R. China, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China; Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
authors: Pei-Rong
authors: PR
authors: Ding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology* / Q000601:surgery; D059248:Chemoradiotherapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
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