Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy

Kurt Catal,Tuba; Can,Günay; Demi̇rel,İsmai̇l Fati̇h; Ergen,Sefi̇ka Arzu; Öksüz,Di̇dem Colpan

doi:10.3892/ol.2025.14995

Risk score model for predicting local control and survival in patients with rectal cancer treated with neoadjuvant chemoradiotherapy

Authors:
- Tuba Kurt Catal
- Günay Can
- İsmai̇l Fati̇h Demi̇rel
- Sefi̇ka Arzu Ergen
- Di̇dem Colpan Öksüz
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Affiliations: Department of Radiation Oncology, Necip Fazıl City Hospital, 46080 Kahramanmaras, Turkey, Department of Public Health, Istanbul University‑Cerrahpasa, Cerrahpasa Medical Faculty, 34098 Istanbul, Turkey, Department of Radiation Oncology, Istanbul University‑Cerrahpasa, Cerrahpasa Medical Faculty, 34098 Istanbul, Turkey
Published online on: March 26, 2025 https://doi.org/10.3892/ol.2025.14995
Article Number: 249
Copyright: © Kurt Catal et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to investigate clinicopathological factors affecting local recurrence and survival in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT) and to create a risk‑scoring model predicting local control (LC) and survival. The clinical and pathological data of 115 patients who received nCRT for LARC between February 2010 and December 2020 were reviewed retrospectively. A risk‑scoring model was developed to predict LC and survival using statistically significant prognostic factors in univariate and multivariate analyses. In the multivariate analysis, the LC rate was improved in patients with a good pathological response to nCRT. By contrast, the disease‑free survival (DFS) rate was significantly worse in patients with perineural invasion (PNI). The overall survival (OS) rate was significantly worse in patients who were >60 years of age, who had tumors ≥5 cm, who were PNI‑positive and who had pathological N2 stage disease. Patients were grouped to analyze the ability of the scoring system to predict LC and survival. The total score was derived by assigning points to the prognostic factors in univariate and multivariate analyses and was subsequently divided into three groups according to tertile. The median LC times in groups 1‑3 were significantly different at 143.6, 97.2 and 93.6 months, respectively. The median DFS times in groups 1‑3 were significantly different at 136.1, 108.5 and 67.2 months, respectively, while the median OS times in groups 1‑3 were significantly different at 138.3, 87.2 and 64.6 months, respectively. In conclusion, risk score modeling with prognostic factors effectively determined the difference in LC and survival between the groups. Adding effective systemic therapy to nCRT may improve results, especially in patients with multiple poor prognostic factors, including larger tumors, PNI and multiple nodal involvement.

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