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Prognostic Factors and Radiotherapy Benefit in pT3N0M0 Rectal Cancer: A Retrospective Analysis
Haina Du1,2, Chunxiang Zhou2, Xinliang Zhang1
1Department of Oncology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
Technology in Cancer Research & Treatment
|July 27, 2026
Summary
Adjuvant radiotherapy improves disease-free survival for stage IIA rectal cancer patients, especially those with specific characteristics. This treatment benefits older patients, those with certain tumor involvement, and CD34-positive cases.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- The role of adjuvant radiotherapy in stage IIA rectal cancer (pT3N0M0) is debated.
- Identifying prognostic factors for recurrence and patient subgroups benefiting from radiotherapy is crucial.
Purpose of the Study:
- To investigate prognostic factors for disease recurrence in stage IIA rectal cancer.
- To identify patient subgroups that may benefit from postoperative radiotherapy-based treatment.
Main Methods:
- Retrospective analysis of 114 stage IIA rectal cancer patients treated between 2017-2023.
- Comparison of outcomes (Disease-Free Survival) across surgery alone, surgery + chemotherapy, and surgery + radiotherapy-based groups.
- Multivariate and subgroup analyses to identify independent prognostic factors and radiotherapy responders.
Main Results:
- Adjuvant radiotherapy and chemotherapy significantly reduced local recurrence compared to surgery alone (P < 0.001).
- Surgery + radiotherapy-based therapy and tumor distance from the anal verge were independent prognostic factors for DFS.
- Efficacy of radiotherapy varied by age, percent circumferential involvement (PCI), and CD34 expression, significantly benefiting older patients (≥60 years), those with PCI 1/2 to 1, and CD34-positive tumors.
Conclusions:
- Postoperative radiotherapy improves DFS in stage IIA rectal cancer, particularly for specific patient subgroups.
- Patients with PCI 1/2 to 1, age ≥ 60 years, and CD34-positive tumors show superior DFS with radiotherapy.
- Prospective randomized trials are needed to validate these findings.