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Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment
To determine the clinical and pathological outcome of locally advanced rectal cancer patients treated with neoadjuvant chemoradiation (chemoradiotherapy [CRT]) followed by curative surgery and to identify predictive factors of pathological complete response (pCR). Locally advanced rectal cancer pati...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462585/ https://www.ncbi.nlm.nih.gov/pubmed/34559161 http://dx.doi.org/10.1097/MD.0000000000027366 |
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author | Suwanthanma, Weerapat Kitudomrat, Saowanee Euanorasetr, Chakrapan |
author_facet | Suwanthanma, Weerapat Kitudomrat, Saowanee Euanorasetr, Chakrapan |
author_sort | Suwanthanma, Weerapat |
collection | PubMed |
description | To determine the clinical and pathological outcome of locally advanced rectal cancer patients treated with neoadjuvant chemoradiation (chemoradiotherapy [CRT]) followed by curative surgery and to identify predictive factors of pathological complete response (pCR). Locally advanced rectal cancer patients undergoing CRT followed by curative surgery from January 2012 to December 2017 were included. Patient's demographic data, pretreatment tumor characteristics, type of CRT regimens, type of surgery, postoperative complications, pathological reports and follow up records were analyzed. Univariate and multivariate analyses were applied to identify predictive factors for pCR. Five-year disease free and overall survival were estimated by Kaplan–Meier method and compared between pCR and non-pCR groups. A total of 85 patients were analyzed. Eighteen patients (21.1%) achieved pCR. The sphincter-saving surgery rate was 57.6%. After univariate analyses, tumor length >4 cm (P = .007) and positive lymph nodes (P = .040) were significantly associated with decreased rate of pCR. Complete clinical response was significantly associated with higher rate of pCR (P = .015). Multivariate analyses demonstrated that tumor length >4 cm (P = .010) was significantly associated with decreased rate of pCR. After a median follow-up of 65 months (IQR 34–79), the calculated 5-year overall survival and disease-free survival rates were 81.4% and 69.7%, respectively. Patients who achieved pCR tend to had longer 5-year disease-free survival (P = .355) and overall survival (P = .361) than those who did not. Tumor length >4 cm was associated with decreased rate of pCR in locally advanced rectal cancer who had CRT followed by surgery. Longer waiting time or more intense adjuvant treatment may be considered to improved pCR and oncological outcomes. |
format | Online Article Text |
id | pubmed-8462585 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-84625852021-09-27 Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment Suwanthanma, Weerapat Kitudomrat, Saowanee Euanorasetr, Chakrapan Medicine (Baltimore) 7100 To determine the clinical and pathological outcome of locally advanced rectal cancer patients treated with neoadjuvant chemoradiation (chemoradiotherapy [CRT]) followed by curative surgery and to identify predictive factors of pathological complete response (pCR). Locally advanced rectal cancer patients undergoing CRT followed by curative surgery from January 2012 to December 2017 were included. Patient's demographic data, pretreatment tumor characteristics, type of CRT regimens, type of surgery, postoperative complications, pathological reports and follow up records were analyzed. Univariate and multivariate analyses were applied to identify predictive factors for pCR. Five-year disease free and overall survival were estimated by Kaplan–Meier method and compared between pCR and non-pCR groups. A total of 85 patients were analyzed. Eighteen patients (21.1%) achieved pCR. The sphincter-saving surgery rate was 57.6%. After univariate analyses, tumor length >4 cm (P = .007) and positive lymph nodes (P = .040) were significantly associated with decreased rate of pCR. Complete clinical response was significantly associated with higher rate of pCR (P = .015). Multivariate analyses demonstrated that tumor length >4 cm (P = .010) was significantly associated with decreased rate of pCR. After a median follow-up of 65 months (IQR 34–79), the calculated 5-year overall survival and disease-free survival rates were 81.4% and 69.7%, respectively. Patients who achieved pCR tend to had longer 5-year disease-free survival (P = .355) and overall survival (P = .361) than those who did not. Tumor length >4 cm was associated with decreased rate of pCR in locally advanced rectal cancer who had CRT followed by surgery. Longer waiting time or more intense adjuvant treatment may be considered to improved pCR and oncological outcomes. Lippincott Williams & Wilkins 2021-09-24 /pmc/articles/PMC8462585/ /pubmed/34559161 http://dx.doi.org/10.1097/MD.0000000000027366 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 7100 Suwanthanma, Weerapat Kitudomrat, Saowanee Euanorasetr, Chakrapan Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
title | Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
title_full | Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
title_fullStr | Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
title_full_unstemmed | Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
title_short | Clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
title_sort | clinical outcome of neoadjuvant chemoradiation in rectal cancer treatment |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462585/ https://www.ncbi.nlm.nih.gov/pubmed/34559161 http://dx.doi.org/10.1097/MD.0000000000027366 |
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