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Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy

BACKGROUND: Adjuvant chemotherapy (ACTx) is recommended in rectal cancer patients after preoperative chemoradiotherapy (PCRT), but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is controversial. AIM: To evaluate the long-term survival benefit of ACTx in pat...

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Autores principales: Jeon, Ye Won, Park, In Ja, Kim, Jeong Eun, Park, Jin-Hong, Lim, Seok-Byung, Kim, Chan Wook, Yoon, Yong Sik, Lee, Jong Lyul, Yu, Chang Sik, Kim, Jin Cheon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462088/
https://www.ncbi.nlm.nih.gov/pubmed/34621476
http://dx.doi.org/10.4240/wjgs.v13.i9.1000
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author Jeon, Ye Won
Park, In Ja
Kim, Jeong Eun
Park, Jin-Hong
Lim, Seok-Byung
Kim, Chan Wook
Yoon, Yong Sik
Lee, Jong Lyul
Yu, Chang Sik
Kim, Jin Cheon
author_facet Jeon, Ye Won
Park, In Ja
Kim, Jeong Eun
Park, Jin-Hong
Lim, Seok-Byung
Kim, Chan Wook
Yoon, Yong Sik
Lee, Jong Lyul
Yu, Chang Sik
Kim, Jin Cheon
author_sort Jeon, Ye Won
collection PubMed
description BACKGROUND: Adjuvant chemotherapy (ACTx) is recommended in rectal cancer patients after preoperative chemoradiotherapy (PCRT), but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is controversial. AIM: To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical resection. METHODS: We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to 2014. Patients with ypT0–1 disease and those who received ACTx were included. The 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) were analyzed according to the status of the ACTx. RESULTS: Of 520 included patients, 413 received ACTx (ACTx group) and 107 did not (no ACTx group). No significant difference was observed in 5-year RFS (ACTx group, 87.9% vs no ACTx group, 91.4%, P = 0.457) and 5-year OS (ACTx group, 90.5% vs no ACTx group, 86.2%, P = 0.304) between the groups. cT stage was associated with RFS and OS in multivariate analysis [hazard ratio (HR): 2.57, 95% confidence interval (CI): 1.07–6.16, P = 0.04 and HR: 2.27, 95%CI: 1.09–4.74, P = 0.03, respectively]. Furthermore, ypN stage was associated with RFS and OS (HR: 4.74, 95%CI: 2.39–9.42, P < 0.00 and HR: 4.33, 95%CI: 2.20–8.53, P < 0.00, respectively), but only in the radical resection group. CONCLUSION: Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement, regardless of the radicality of resection. Further trials are needed to evaluate the efficacy of ACTx in these group of patients.
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spelling pubmed-84620882021-10-06 Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy Jeon, Ye Won Park, In Ja Kim, Jeong Eun Park, Jin-Hong Lim, Seok-Byung Kim, Chan Wook Yoon, Yong Sik Lee, Jong Lyul Yu, Chang Sik Kim, Jin Cheon World J Gastrointest Surg Retrospective Study BACKGROUND: Adjuvant chemotherapy (ACTx) is recommended in rectal cancer patients after preoperative chemoradiotherapy (PCRT), but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is controversial. AIM: To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical resection. METHODS: We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to 2014. Patients with ypT0–1 disease and those who received ACTx were included. The 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) were analyzed according to the status of the ACTx. RESULTS: Of 520 included patients, 413 received ACTx (ACTx group) and 107 did not (no ACTx group). No significant difference was observed in 5-year RFS (ACTx group, 87.9% vs no ACTx group, 91.4%, P = 0.457) and 5-year OS (ACTx group, 90.5% vs no ACTx group, 86.2%, P = 0.304) between the groups. cT stage was associated with RFS and OS in multivariate analysis [hazard ratio (HR): 2.57, 95% confidence interval (CI): 1.07–6.16, P = 0.04 and HR: 2.27, 95%CI: 1.09–4.74, P = 0.03, respectively]. Furthermore, ypN stage was associated with RFS and OS (HR: 4.74, 95%CI: 2.39–9.42, P < 0.00 and HR: 4.33, 95%CI: 2.20–8.53, P < 0.00, respectively), but only in the radical resection group. CONCLUSION: Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement, regardless of the radicality of resection. Further trials are needed to evaluate the efficacy of ACTx in these group of patients. Baishideng Publishing Group Inc 2021-09-27 2021-09-27 /pmc/articles/PMC8462088/ /pubmed/34621476 http://dx.doi.org/10.4240/wjgs.v13.i9.1000 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Retrospective Study
Jeon, Ye Won
Park, In Ja
Kim, Jeong Eun
Park, Jin-Hong
Lim, Seok-Byung
Kim, Chan Wook
Yoon, Yong Sik
Lee, Jong Lyul
Yu, Chang Sik
Kim, Jin Cheon
Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
title Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
title_full Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
title_fullStr Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
title_full_unstemmed Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
title_short Evaluating the benefit of adjuvant chemotherapy in patients with ypT0–1 rectal cancer treated with preoperative chemoradiotherapy
title_sort evaluating the benefit of adjuvant chemotherapy in patients with ypt0–1 rectal cancer treated with preoperative chemoradiotherapy
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462088/
https://www.ncbi.nlm.nih.gov/pubmed/34621476
http://dx.doi.org/10.4240/wjgs.v13.i9.1000
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