Association between adjuvant chemotherapy and survival in patients with rectal cancer and pathological complete response after neoadjuvant chemoradiotherapy and resection
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: For patients with locally advanced rectal cancer (LARC), it is unclear whether neoadjuvant chemoradiotherapy-induced pathologic complete response (pCR) individuals would further benefit from adjuvant chemotherapy (ACT). METHODS: The pCR individuals who received different ACT cycles were paired by propensity score matching. Overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated by Kaplan-Meier and log-rank test. RESULTS: In total, 1041 pCR individuals were identified from 5567 LARC cases. Specifically, 303 pCR cases had no ACT treatment, and 738 pCR patients received fluoropyrimidine-based ACT (median, 4 cycles) treatment. After 1:3 propensity score matching, 297 cases without ACT treatment were matched to 712 cases who received ACT treatment. Kaplan-Meier analysis showed that pCR individuals treated with or without ACT had the similar 3-year outcome (OS, DFS, LRFS and DMFS) (all P > 0.05). Moreover, the pCR patients received different ACT cycle(s) (0 vs. 1-4 cycles, 0 vs. ≥5 cycles) had comparable 3-year OS, DFS, LRFS and DMFS (all P > 0.05). In stratified analysis, ACT treatment did not improve 3-year survival (OS, DFS, LRFS and DMFS) for the baseline high-risk (cT3-4/cN1-2) subgroup patients (all P > 0.05). CONCLUSION: ACT, which did not improve survival, is unnecessary to neoadjuvant treatment-induced pCR LARC patients. TRIAL REGISTRATION: 2019ZSLYEC-136 (24-6-2019).
Source: British Journal of Cancer
Authors: Fang He, Huai-Qiang Ju, Yi Ding, Zhiqiang Jiang, Zhenhui Li, Bo Huang, Xiuhong Wang, Yuanyuan Zhao, Yong Li, Bin Qi, Wenguang Luo, Zijian Zhang, Qian Pei, Haiyang Chen, Shuai Liu, Xiaolin Pang, Jian Zheng, Jianping Wang, Jaffer A. Ajani, Xiang-Bo Wan
Institutions: Sixth Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Nanfang Hospital, Southern Medical University, Zhengzhou University, Henan Cancer Hospital, Kunming Medical University, Liaoning Cancer Hospital & Institute, China Medical University, China-Japan Friendship Hospital, Qingdao University, Affiliated Hospital of Qingdao University, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou Medical University Cancer Hospital, Guangzhou Medical University, University of Science and Technology of China, Xiangya Hospital Central South University, The University of Texas MD Anderson Cancer Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,300
Awards: G2542698243, G5233836633, G5687324539
OpenAlex ID: W3046189029