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Int J Hyperthermia. 2018 Jun;34(4):455-460. doi: 10.1080/02656736.2017.1338364. Epub 2017 Jul 26.

External validation of a rectal cancer outcome prediction model with a cohort of patients treated with preoperative radiochemotherapy and deep regional hyperthermia.

Author information

1
a Department of Radiation Oncology , University Hospital and Medical Faculty Tübingen, Eberhard Karls University Tübingen , Tübingen , Germany.
2
b Radiotherapy Unit , Azienda Ospedaliero Universitaria Careggi, University of Florence , Florence , Italy.
3
c Gastrointestinal Cancer Center , Comprehensive Cancer Center Tübingen-Stuttgart , Tübingen , Germany.
4
d German Cancer Consortium (DKTK), partner site Tübingen; and German Cancer Research Center (DKFZ) , Heidelberg , Germany.

Abstract

PURPOSE:

To validate a nomogram for the prediction of treatment outcomes after preoperative radiochemotherapy and surgery for locally advanced rectal cancer with a cohort of patients treated with additional deep regional hyperthermia.

PATIENTS AND METHODS:

A total of 86 patients were treated with preoperative radiochemotherapy and deep regional hyperthermia at our institution. For every patient, the 5-year probability for death, distant metastases and local failure based on a previously published nomogram were calculated and patients were divided into three risk groups.

RESULTS:

Low-lying and clinically lymph node positive tumours were more frequent in the validation cohort. Five-year Kaplan-Meier estimates for overall survival (OS), distant metastases-free survival (DMFS) and local control (LC) were 87.3%, 79.9%, 95.8% (observed) and 75.5%, 71%, 90% (predicted), respectively. Discrimination between low- and high-risk groups was at a significant level for all endpoints. The c-index was 0.81 (OS), 0.67 (DMFS) and 0.92 (LC), respectively.

CONCLUSIONS:

The nomogram showed reasonable performance when deep regional hyperthermia is incorporated into preoperative therapy. The higher than predicted rates seen for OS and DMFS in particular in the high-risk groups warrant further prospective validation and subsequent investigation of the underlying mechanisms.

KEYWORDS:

Predictive model; hyperthermia; nomogram; prognostic factors; radiochemotherapy; rectal cancer

PMID:
28747080
DOI:
10.1080/02656736.2017.1338364
[Indexed for MEDLINE]

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