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Tumor Stage, Node Status Predict Rectal Cancer Outcome

Five-year survival is 63 percent after treatment of T4 stage tumors

WEDNESDAY, July 12 (HealthDay News) -- A rectal cancer patient's pathologic T and N stages at diagnosis are significant predictors of recurrence, metastasis and survival after surgery and chemoradiation, suggesting those with a more advanced pathologic stage should be treated more aggressively, according to a report in the June issue of the American Journal of Clinical Oncology.

Prajnan Das, M.D., M.S., M.P.H., from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues followed 470 patients with rectal cancer treated pre- or post-operatively with chemoradiation. Median radiation dosage was 45 Gray and most received 5-fluorouracil.

Female sex and pathologic T and N stage were predictors of local recurrence and metastasis in both univariate and multivariate analyses. Pathologic T and N stage also predicated overall survival with only 63 percent of patients with T4 tumors surviving after five years, the investigators found.

"These findings imply that trials of more aggressive adjuvant chemotherapy agents are warranted for rectal cancer patients with pathologic stage T3/T4 or node-positive disease," the authors conclude.

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