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Rectal cancer patients with downstaging after neoadjuvant chemoradiotherapy and radical resection do not benefit from adjuvant chemotherapy.
Zhang, Hang; Huang, Ya; Sun, Ge; Zheng, Kuo; Lou, Zheng; Gao, Xian-Hua; Hao, Li-Qiang; Liu, Lian-Jie; Meng, Rong-Gui; Zhang, Wei.
Afiliação
  • Zhang H; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Huang Y; Department of Life Sciences, Shanghai Tech University, Shanghai, China.
  • Sun G; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Zheng K; Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
  • Lou Z; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Gao XH; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Hao LQ; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Liu LJ; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Meng RG; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
  • Zhang W; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
Ann Transl Med ; 8(12): 743, 2020 Jun.
Article em En | MEDLINE | ID: mdl-32647668
BACKGROUND: Whether adjuvant chemotherapy is beneficial for rectal cancer patients who respond well to neoadjuvant chemoradiotherapy (NCRT) and undergo radical resection is controversial. This study aimed to assess the effect of adjuvant chemotherapy on the oncological outcomes of ypT0-2N0 rectal cancer patients after NCRT and radical resection, and identify the prognostic factors. METHODS: The clinical and pathological data of rectal cancer patients with ypT0-2N0 who underwent NCRT and radical resection between January, 2010 and June, 2018 were collected and retrospectively analyzed. The oncological outcomes of the chemotherapy (chemo) group and the non-chemotherapy (non-chemo) group were compared. Multivariate analysis, using a Cox proportional hazard model, was performed to identify independent predictors of oncological outcome. RESULTS: Of the 121 rectal cancer patients enrolled, 90 patients received postoperative adjuvant chemotherapy with no fewer than 3 cycles (the chemo group), and the other 31 patients with fewer than 3 cycles (the non-chemo group). There was no significant difference in the 5-year disease-free survival (DFS) or overall survival (OS) rates between the two groups (DFS: 79.1% vs. 82.9%, P=0.442; OS: 87.5% vs. 78.2%, P=0.667). cT4 is an independent risk factor for OS (HR =4.227, 95% CI: 1.128-15.838, P=0.02) and DFS (HR =4.878, 95% CI: 1.752-13.578). Preoperative consolidation chemotherapy with Capeox or FOLFOX after NCRT significantly improved the DFS rate (HR =0.212, 95% CI: 0.058-0.776, P=0.019). CONCLUSIONS: Rectal cancer patients with ypT0-2N0 who underwent NCRT and radical resection did not benefit significantly from postoperative adjuvant chemotherapy. For these patients, cT4 was an independent risk factor for OS and DFS. Preoperative consolidation chemotherapy with Capeox or FOLFOX after NCRT can significantly improve DFS.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2020 Tipo de documento: Article