Lateral lymph node recurrence and induction chemotherapy 65 CHAPTER 4 Distant metastasis Cancer-specific survival Overall survival HR CI P-value HR CI P-value HR CI P-value 1.00 0.205 1.00 0.458 1.00 0.638 0.49 0.16-1.48 0.66 0.22-1.96 0.79 0.29-2.15 1.00 0.185 1.00 0.152 1.00 0.093 0.52 0.20-1.37 2.19 0.75-6.42 2.46 0.86-7.03 1.00 0.791 1.00 0.974 1.00 0.719 1.16 0.38-3.54 0.98 0.21-4.50 0.76 0.17-3.42 1.00 0.628 1.00 0.818 1.00 0.908 0.82 0.30-2.29 1.06 0.38-2.99 1.09 0.39-3.08 1.43 0.45-4.59 0.64 0.12-3.29 1.34 0.36-4.97 1.00 0.255 1.00 0.002 1.00 0.002 3.22 0.43-24.1 7.56 2.13-26.9 5.81 1.89-17.9 1.00 0.031 1.00 0.002 1.00 0.002 2.82 1.10-7.21 7.57 2.13-26.9 5.81 1.89-17.9 NA NA NA 1.00 0.724 1.00 0.961 1.32 0.29-6.09 1.04 0.23-4.68 patients who had an R+ resection compared with patients who had an R0 resection (P = 0.004). In univariate analyses, OS was influenced by sex, complete response and margin involvement (Table 4) but, as in CSS, margin involvement was the only factor that remained significant after multivariate analyses. Figure 1 shows 5-year OS after multivariate analyses, i.e., 10.3 percent after anR+ resection comparedwith66.8percent after an R0 resection (P = 0.011). Figure 1. Overall survival according to margin status after multivariate analyses DISCUSSION This study evaluated the treatment of 51 patients with latLR, from a total of 214 patients with LRRC who underwent multimodality treatment in our national tertiary 0,0 0,1 0,2 0,3 0,4 0,5 0,6 0,7 0,8 0,9 1,0 12 0 24 Follow-up (months) Survival 36 48 R0 resection R+ resection 60 FIG. 1 Overall survival according to margin status after multivariate analyses TABLE 1 Patient and treatment characteristics Median age [years (range)] Sex Male Female Stage of primary tumor I II III Type of primary surgery Rectosigmoid resection Low anterior resection Abdominoperineal resection (Neo)adjuvant treatment for primary tumor None Preoperative 5 95 radiotherapy Preoperative long-course radiotherapy Preoperative chemoradiotherapy Postoperative long-course radiotherapy M
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