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Association between adjuvant chemotherapy and survival in patients with rectal cancer and pathological complete response after neoadjuvant chemoradiotherapy and resection

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机构： [1]Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China [2]Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South Chin, Sun Yat-sen University Cancer Center, Guangzhou, China [3]Department of Radiation Oncology, Nanfang Hospital of Southern Medical University, Guangzhou, China [4]Department of General Surgery, Henan Cancer Hospital, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China [5]Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, China [6]Central Laboratory, Department of Pathology, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Liaoning, China [7]Department of Pathology, China-Japan Friendship Hospital, Beijing, China [8]Department of Radiation Oncology, The Affiliated Hospital of Qingdao University Medical College, Qingdao, China [9]Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China [10]Department of Radiation Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China [11]Department of Radiation Oncology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, China [12]Department of Radiation Oncology, Xiangya Hospital Central South University, Changsha, China [13]Department of General Surgery, Xiangya Hospital Central South University, Changsha, China [14]Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China [15]Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

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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) (allP > 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 (allP > 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 (allP > 0.05). Conclusion ACT, which did not improve survival, is unnecessary to neoadjuvant treatment-induced pCR LARC patients.

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出版当年[2020]版：

大类 | 2 区

医学

小类 | 2 区肿瘤学

最新[2023]版：

大类 | 1 区

医学

小类 | 2 区肿瘤学

JCR分区：

出版当年[2019]版：

Q1 ONCOLOGY

最新[2023]版：

Q1 ONCOLOGY

影响因子： 6.4 最新[2023版] 8.1 最新五年平均 5.791 出版当年[2019版] 6.21 出版当年五年平均 5.416 出版前一年[2018版] 7.64 出版后一年[2020版]

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第一作者机构： [1]Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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