Can the new American Joint Committee on Cancer staging system predict survival in rectal cancer patients treated with curative surgery following preoperative chemoradiotherapy?

Abstract

BACKGROUND: Although ypStage has been known as a strong prognosticator of recurrence and survival, the detailed interaction of ypT and ypN classification on a survival rate has never been evaluated. METHODS: Between October 2001 and December 2007, in total, 960 patients with locally advanced rectal cancer were enrolled retrospectively at 3 centers. Five-year overall survival (OS) and disease-free survival (DFS) rate were calculated for each ypTN classification. RESULTS: The ypT classification interacted with ypN classification to affect survival in most categories. Patients with ypStage 0 and I cancers showed a >90% 5-year OS (ypStage 0, 96.5%; ypStage I, 92.9%; P =.346) and 5-year DFS (ypStage 0, 90.2%; ypStage I, 90.7%; P =.879). Among ypStage III subgroups, large differences in 5-year OS (ypStage IIIA, 90.1%; ypStage IIIB, 68.3%; ypStage IIIC, 40.5%; P