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Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis

PURPOSE: The role of adjuvant chemotherapy for patients with ypT0–2N0 rectal cancer following neoadjuvant chemoradiotherapy (nCRT) and curative surgery is uncertain. We performed a meta-analysis using selected studies to compare adjuvant chemotherapy with observation for this cohort of patients. MET...

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Autores principales: Ha, Gi Won, Lee, Min Ro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406397/
https://www.ncbi.nlm.nih.gov/pubmed/32802815
http://dx.doi.org/10.4174/astr.2020.99.2.97
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author Ha, Gi Won
Lee, Min Ro
author_facet Ha, Gi Won
Lee, Min Ro
author_sort Ha, Gi Won
collection PubMed
description PURPOSE: The role of adjuvant chemotherapy for patients with ypT0–2N0 rectal cancer following neoadjuvant chemoradiotherapy (nCRT) and curative surgery is uncertain. We performed a meta-analysis using selected studies to compare adjuvant chemotherapy with observation for this cohort of patients. METHODS: PubMed, Embase, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random effect models. Outcome measures were 5-year overall survival (OS), disease-free survival (DFS), local, and distant recurrence. RESULTS: We included 17 nonrandomized studies for qualitative analysis and 16 nonrandomized studies that examined 4,747 patients for the meta-analysis. In analysis of patients with ypT0N0 rectal cancer, adjuvant chemotherapy had no significant effect on OS (odds ratio [OR], 1.53; 95% confidence interval [CI], 0.86–2.72; I(2) = 27%), DFS (OR, 1.22; 95% CI, 0.61–2.42; I(2) = 5%), local recurrence (OR, 0.78; 95% CI, 0.08–7.37; I(2) = 0%), and distant recurrence (OR, 1.04; 95% CI, 0.41–2.62; I(2) = 0%). In analysis of patients with ypT1–2N0 rectal cancer, adjuvant chemotherapy also had no significant effect on OS (OR, 2.15; 95% CI, 0.59–7.80; I(2) = 26%), DFS (OR, 1.66; 95% CI, 0.35–7.85; I(2) = 44%), local recurrence (OR, 2.56; 95% CI, 0.72–9.13; I(2) = 0%), and distant recurrence (OR, 1.15; 95% CI, 0.23–5.87; I(2) = 0%). CONCLUSION: Adjuvant chemotherapy may have no oncologic benefits in patients with ypT0–2N0 rectal cancer after nCRT and radical surgery. Routine use of adjuvant chemotherapy for those patients may be avoided.
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spelling pubmed-74063972020-08-13 Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis Ha, Gi Won Lee, Min Ro Ann Surg Treat Res Original Article PURPOSE: The role of adjuvant chemotherapy for patients with ypT0–2N0 rectal cancer following neoadjuvant chemoradiotherapy (nCRT) and curative surgery is uncertain. We performed a meta-analysis using selected studies to compare adjuvant chemotherapy with observation for this cohort of patients. METHODS: PubMed, Embase, and the Cochrane Library were searched. Data were pooled, and overall effect size was calculated using random effect models. Outcome measures were 5-year overall survival (OS), disease-free survival (DFS), local, and distant recurrence. RESULTS: We included 17 nonrandomized studies for qualitative analysis and 16 nonrandomized studies that examined 4,747 patients for the meta-analysis. In analysis of patients with ypT0N0 rectal cancer, adjuvant chemotherapy had no significant effect on OS (odds ratio [OR], 1.53; 95% confidence interval [CI], 0.86–2.72; I(2) = 27%), DFS (OR, 1.22; 95% CI, 0.61–2.42; I(2) = 5%), local recurrence (OR, 0.78; 95% CI, 0.08–7.37; I(2) = 0%), and distant recurrence (OR, 1.04; 95% CI, 0.41–2.62; I(2) = 0%). In analysis of patients with ypT1–2N0 rectal cancer, adjuvant chemotherapy also had no significant effect on OS (OR, 2.15; 95% CI, 0.59–7.80; I(2) = 26%), DFS (OR, 1.66; 95% CI, 0.35–7.85; I(2) = 44%), local recurrence (OR, 2.56; 95% CI, 0.72–9.13; I(2) = 0%), and distant recurrence (OR, 1.15; 95% CI, 0.23–5.87; I(2) = 0%). CONCLUSION: Adjuvant chemotherapy may have no oncologic benefits in patients with ypT0–2N0 rectal cancer after nCRT and radical surgery. Routine use of adjuvant chemotherapy for those patients may be avoided. The Korean Surgical Society 2020-08 2020-07-31 /pmc/articles/PMC7406397/ /pubmed/32802815 http://dx.doi.org/10.4174/astr.2020.99.2.97 Text en Copyright © 2020, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Ha, Gi Won
Lee, Min Ro
Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
title Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
title_full Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
title_fullStr Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
title_full_unstemmed Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
title_short Oncologic effects of adjuvant chemotherapy in patients with ypT0–2N0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
title_sort oncologic effects of adjuvant chemotherapy in patients with ypt0–2n0 rectal cancer after neoadjuvant chemoradiotherapy and curative surgery: a meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406397/
https://www.ncbi.nlm.nih.gov/pubmed/32802815
http://dx.doi.org/10.4174/astr.2020.99.2.97
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