Abstract book - ESTRO meets Asia

S33 ESTRO meets Asia 2018

aimed to examine factors associated with LNY and its prognostic significance in LARC patients with neo-CRT. Material and Methods We retrospectively analyzed 495 LARC patients following neo-CRT and surgery between 2006 and 2014. Clinicopathological features, overall survival (OS), disease free survival (DFS), local recurrence free survival (LRFS) and distant metastasis free survival (DMFS) were recorded. The patients were separated into two groups: LNY < 12 group and LNY≥12 group. The chi-square test was used to compare differences in the distributions of the clinicopathological variables by LNY group. Univariate and multivariate analysis were performed using the Kaplan- Meier method and the Cox proportional hazards regression in all patients. Results Of the 495 patients, an LNY of less than 12 were found in 287 (57.98%) cases. There were no significant differences in the distributions of the clinicopathological variables by LNY group, including age, gender, distance from anus, type of surgical procedure, tumor grade, cTNM staging and ypTNM staging (all P ＞ 0.05). And no association was found between LNY group and tumor regression grade (TRG) (P = 0.499). Kaplan-Meier method and univariate analysis showed that LNY≥12 group had better OS (P = 0.030), DFS (P = 0.012) and DMFS (P = 0.011) compared with LNY < 12 group, but not LRFS (P = 0.293). In multivariate analysis, LNY≥12 was an independent good prognostic factor of OS (HR 0.522, 95%CI 0.338-0.804, P = 0.003), DFS (HR 0.595, 95%CI 0.430-0.823, P = 0.002) and DMFS (HR 0.583, 95%CI 0.398-0.853, P = 0.005) in all patients, but not LRFS (HR 0.597, 95%CI 0.326-1.091, P = 0.093). Conclusion Increased lymph node yield (LNY≥12) was an independent good prognostic factor in locally advanced rectal cancer with neoadjuvant chemoradiotherapy, and lower lymph node yield (LNY < 12) is not associated with good tumor response. It indicates that these patients probably still need enough number of lymph node yield (≥12) even though they received neoadjuvant chemoradiotherapy. OC-084 The Predictive and Prognostic Significance of SFRP2 in Locally Advanced Rectal Cancer Patients J. Zhang 1 , L. Shen 1 , Y. Wang 1 , X. Sun 1 , Y. Deng 1 , Z. Zhang 1 , W. Zou 1 , H. Zhang 1 , L. Yang 1 , J. Wan 1 , F. Xia 1 , J. Zhu 1 , Z. Zhang 1 1 Fudan University Shanghai Cancer Center, Radiation Oncology, Shanghai, China Purpose or Objective Previous studies found that the expression of SFRP2 mRNA was different in locally advanced rectal cancer. Deregulation of SFRP2 has been found in many types of cancer. However, the pattern of SFRP2 expression in rectal cancer is still unclear. Material and Methods Retrospectively collected 220 pairs of surgically resected tissue and paracancerous frozen specimens of patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation and surgery from January 2007 to December 2012 in Fudan University Shanghai Cancer Hospital. Except for 23 pairs of samples failed to meet the qRT-PCR test requirements, a total of 197 patients were included in the study. The median follow- up tiem was 58 months. Real time PCR was used to study the relationship between SFRP2 mRNA expression and survival, recurrence, metastasis and neoadjuvant chemoradiotherapy. Results In all patients, 5-year overall survival (OS), tumor-free survival (DFS), local recurrence (LR), and distant metastasis (DM) were 73.9%, 65.4%, 11.7%, and 28.2%, respectively. Common clinical and pathological factors such as sex, age, tumor location, tumor stage before

radiotherapy, and postoperative pathological vascular invasion were not significantly associated with SFRP2 levels. Postoperative pathological nerve invasion was associated with SFRP2 expression. The 5-year OS of patients with low expression of SFRP2 and high expression was 83.9% and 65.3% (P=0.011), and the 5-year DFS was 87.4% and 43.7% (P=0.010). The 5-year distant metastasis rates were 18.4% and 43.1% (P=0.010), the 5-year local recurrence rates were 13.1% and 10.3%, respectively (P=0.503). SFRP2 has a good ability to predict the efficacy of neoadjuvant chemo-radiotherapy, and its area under the ROC curve (AUC) for prediction of good response (TRG 0-1) and poor response (TRG 2-3) is 0.619 (p = 0.003). By univariate analysis and multivariate analysis, it was found that SFRP2 is an independent influence factor of OS, DFS and distant metastasis. Conclusion Patients with locally advanced rectal cancer with high expression of SFRP2 are more likely to have distant metastasis. The survival status is worse than those with low expression of SFRP2, and the response to neoadjuvant chemoradiotherapy is also poor. It needs to be further verified in vitro and large-scale clinical data. OC-085 Externally validated nomogram for response prediction based on immune inflammation in anal cancer P. Franco 1 , F. Arcadipane 1 , G. Iorio 1 , F. Olivero 1 , V. Chiofalo 1 , F. Montagnani 2 , D. Aloi 3 , A. Casadei Gardini 4 , B. De Bari 5 , S. Cascinu 6 , U. Ricardi 1 1 University of Turin, Department of Oncology- Radiation Oncology, Turin, Italy 2 AO Biella, Medical Oncology, Biella, Italy 3 Centre Hospitalier Régional Universitaire Jean Minjoz- INSERM U1098 EFS/BFC, Department of Radiation Oncology, Besancon, France 4 Istituto Scientifico Romagnolo per lo Studio e la Cura de i Tumori IRST IRCCS, Department of Medical Oncology, Meldola, Italy 5 Centre Hospitalier Régional Universitaire Jean Minjoz- INSERM U1098 EFS/BFC, Department of Radiation Oncology, Besancon, France 6 Modena Cancer Center, Department of Oncology/Hematology, Modena, Italy Purpose or Objective In anal cancer, there are no markers nor other laboratory indexes able to predict prognosis and guide clinical practice for patients treated with concurrent chemo- radiation (CT-RT). In the present study, we retrospectively investigated the influence of immune inflammation indicators on treatment outcome of anal cancer patients undergoing concurrent CT-RT. Material and Methods All patients had a histologically proven diagnosis of squamous cell carcinoma of the anal canal/margin treated with CT-RT according to the Nigro’s regimen. Impact on prognosis of pre-treatment systemic index of inflammation (SII) (platelet x neutrophil/lymphocyte), neutrophil-lymphocyte ratio (NLR) and platelet- lymphocyte ratio (PLR) were analysed. A nomogram was created to predict for response/non-response to treatment based on immune inflammatory indicators and clinical factors. The nomogram was then externally validated on a different set of anal cancer patients, treated at different Institutions. Results A total of 161 consecutive patients treated at 3 Italian Institutions was available for the analysis. Response to treatment was the single most important factor for progression-free survival (PFS) and overall survival (OS). At univariate analysis, a higher SII level was significantly correlated to lower PFS (p<0.01) and OS (p=0.046). NLR level was significantly correlated to PFS (p=0.05), but not