Is routine use of adjuvant chemotherapy for rectal cancer with complete pathological response justified?

Maysoon Gamaleldin; James M Church; Luca Stocchi; Mathew Kalady; David Liska; Emre Gorgun

doi:10.1016/j.amjsurg.2016.11.028

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Is routine use of adjuvant chemotherapy for rectal cancer with complete pathological response justified?

Journal article

Peer reviewed

Is routine use of adjuvant chemotherapy for rectal cancer with complete pathological response justified?

Maysoon Gamaleldin, James M Church, Luca Stocchi, Mathew Kalady, David Liska and Emre Gorgun

The American journal of surgery, Vol.213(3), pp.478-483

03/01/2017

DOI: 10.1016/j.amjsurg.2016.11.028

PMID: 27939008

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Abstract

Patients with locally advanced rectal cancer (LARC) receiving neoadjuvant chemoradiation (nCRT) can have a complete pathologic response (pCR), and are given postoperative adjuvant chemotherapy (ACT). A prospectively maintained outcomes database was queried for patients who had pCR to nCRT for LARC from 2000 to 2012. Local recurrence and survival were analyzed according to whether patients received ACT. We identified 139 patients and excluded 9 due to lack of follow-up. Mean age was 58.9 ± 11.8 years. 83 patients (63.8%) did not receive ACT (Group A) and 47 (36.2%) did (Group B). Mean follow-up was 5.7 ± 3 and 5.6 ± 3.5 years for Groups A and B respectively (p = 0.51). Groups were comparable in age, gender, tumor differentiation, and clinical staging. There were no differences in oncological outcomes. Avoiding routine use of ACT in patients with a pCR may be considered. Further justification of this approach warrants prospective randomized studies.

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Chemoradiotherapy

Chemotherapy, Adjuvant

Disease-Free Survival

Female

Fluorouracil - administration & dosage

Follow-Up Studies

Humans

Leucovorin - administration & dosage

Male

Middle Aged

Neoadjuvant Therapy

Neoplasm Metastasis

Neoplasm Recurrence, Local

Prospective Studies

Rectal Neoplasms - mortality

Rectal Neoplasms - therapy

Details

Title: Subtitle: Is routine use of adjuvant chemotherapy for rectal cancer with complete pathological response justified?
Creators: Maysoon Gamaleldin - Cleveland Clinic
James M Church - Cleveland Clinic
Luca Stocchi - Cleveland Clinic
Mathew Kalady - Cleveland Clinic
David Liska - Cleveland Clinic
Emre Gorgun - Cleveland Clinic
Resource Type: Journal article
Publication Details: The American journal of surgery, Vol.213(3), pp.478-483
DOI: 10.1016/j.amjsurg.2016.11.028
PMID: 27939008
NLM abbreviation: Am J Surg
ISSN: 0002-9610
eISSN: 1879-1883
Language: English
Date published: 03/01/2017
Academic Unit: Surgery
Record Identifier: 9984966745102771

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