1. The potential benefit of adjuvant chemotherapy in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy is not predicted by tumor regression grade
- Author
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Maria Gomez-Galdon, J. Vandestadt, Ali Bohlok, I. Elnakadi, B. Fikri, Alain Hendlisz, Luigi Moretti, and Gabriel Liberale
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Male ,Oncology ,Adjuvant chemotherapy ,Colorectal cancer ,law.invention ,Tumor regression grade ,0302 clinical medicine ,Randomized controlled trial ,law ,Gastro-entérologie ,Medicine ,Overall survival ,Prospective Studies ,030212 general & internal medicine ,Rectal cancer ,Aged, 80 and over ,Tumor Regression Grade ,education.field_of_study ,Gastroenterology ,Chemoradiotherapy ,General Medicine ,Middle Aged ,Total mesorectal excision ,Neoadjuvant Therapy ,Neoadjuvant chemoradiotherapy ,Treatment Outcome ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,Adult ,medicine.medical_specialty ,Disease-free survival ,Population ,Locally advanced ,Disease-Free Survival ,03 medical and health sciences ,Internal medicine ,Humans ,education ,Aged ,Neoplasm Staging ,Retrospective Studies ,Rectal Neoplasms ,business.industry ,Dworak ,Chemoradiotherapy, Adjuvant ,Hepatology ,medicine.disease ,Regimen ,Surgery ,business - Abstract
Introduction: Recommended treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiotherapy (NACRT) followed by surgery and total mesorectal excision (TME). The role of adjuvant chemotherapy (ACT) in this regimen is still debated. Assessment of Dworak’s tumor regression grade (TRG) after NACRT could potentially select patients who might benefit from ACT. Materials and methods: Data for patients who underwent NACRT and TME for LARC between 2007 and 2014 were retrieved from the Bordet Institute database. Overall survival (OS) and disease-free survival (DFS) were calculated for the whole population, according to whether or not they received ACT, and according to TRG. Results: We included 74 patients (38 males) with a median age of 62.7 years (33–84 years). AJCC stage cIIIb disease was the most frequent (73%). Pathologic complete response (pCR) was achieved in 13 patients (17.6%). ACT was administered to 42 patients (56.8%). Five-year OS and DFS of patients who received ACT or not were 92 and 84.5% (p = ns), and 79.9 and 84.8% (p = ns), respectively. OS was related to TRG (cut-off value of 3) (p = 0.001). ACT administration was not correlated with improved outcomes in any TRG groups. Conclusion: TRG is a prognostic factor for both OS and DFS but does not appear to have a significant benefit for the selection of patients with LARC treated with NACRT who might benefit from the administration of ACT. Prospective randomized trials with larger populations are needed to identify factors that predict which patients may benefit from the administration of ACT., SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2018
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