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Treatment Interval between Neoadjuvant Chemoradiotherapy and Surgery in Rectal Cancer Patients: A Population-Based Study
- Source :
- Annals of Surgical Oncology, 23, 11, pp. 3593-601, Annals of Surgical Oncology, 23, 3593-601, Annals of Surgical Oncology
- Publication Year :
- 2016
-
Abstract
- Background Neoadjuvant chemoradiation therapy (CRT) has been widely implemented in the treatment of rectal cancer patients, but optimal timing of surgery after neoadjuvant therapy is unclear. The purpose of this study was to evaluate the effects of prolonged intervals between long-course CRT and surgery in rectal cancer patients. Methods Data on all rectal cancer patients diagnosed between 2006 and 2011 were retrieved from the population-based Netherlands Cancer Registry; the main outcome parameters were pathologic complete response (pCR) and overall survival (OS). Outcomes were reported separately for patients with early tumors (ETs; N = 217) and locally advanced rectal cancer (LARC; N = 1073). Patients were divided into 2-week interval groups according to treatment interval, ranging from 5–6 to 13–14 weeks. Kaplan–Meier curves, and logistic regression and Cox regression models were used for data analysis. Results No significant difference in pCR rate was observed for ET patients according to treatment interval. Compared with a treatment interval of 7–8 weeks, pCR rates in LARC patients were higher after 9–10 weeks (18.4 %; odds ratio [OR] 1.56, 95 % CI 1.03–2.37) and 11–12 weeks of treatment interval (20.8 %; OR 1.94, 95 % CI 1.15–3.26). Treatment interval did not influence OS in ET or LARC patients. Conclusions Treatment intervals of 9–12 weeks between surgery and CRT seem to improve the chances of pCR in LARC patients, without an effect on OS. The length of treatment interval did not affect outcomes in patients with ET. The ongoing search for minimally invasive surgery drives the need for exploration of factors that improve pathologic response. Electronic supplementary material The online version of this article (doi:10.1245/s10434-016-5294-0) contains supplementary material, which is available to authorized users.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
genetic structures
Colorectal cancer
medicine.medical_treatment
Treatment interval
Kaplan-Meier Estimate
Adenocarcinoma
030230 surgery
03 medical and health sciences
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
0302 clinical medicine
Surgical oncology
medicine
Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14]
Humans
Registries
Survival rate
Neoadjuvant therapy
Aged
Neoplasm Staging
Netherlands
Proportional Hazards Models
Colorectal Cancer
Aged, 80 and over
Rectal Neoplasms
business.industry
Proportional hazards model
Chemoradiotherapy, Adjuvant
Middle Aged
medicine.disease
Neoadjuvant Therapy
Surgery
Survival Rate
Oncology
030220 oncology & carcinogenesis
Female
business
Chemoradiotherapy
Neoadjuvant chemoradiotherapy
Subjects
Details
- ISSN :
- 10689265
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology, 23, 11, pp. 3593-601, Annals of Surgical Oncology, 23, 3593-601, Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....06b4a062c6a38e5bc3b4ba3d72ea46b4