The role of adjuvant chemotherapy on survival and recurrence after curative rectal cancer surgery on patients who are histologically node negative after neoadjuvant chemoradiotherapy.
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
AIM: The aim of this study is to evaluate whether adjuvant chemotherapy will affect recurrence rates, disease free and overall survival in patients with rectal adenocarcinoma who were staged with MRI node positive disease (mrN+) preoperatively and underwent neoadjuvant chemoradiotherapy with curative rectal cancer surgery and their pathological staging was negative for nodal disease (ypN0). There is no consensus on the role of adjuvant chemotherapy in these patients. METHOD: Patients who received neoadjuvant chemoradiotherapy and underwent curative rectal cancer surgery for rectal adenocarcinoma staged as [mrTxN+M0] on MRI staging and on pathological staging were found to be [ypTxN0M0] were retrospectively identified from 01/2008-12/2012 from two tertiary referral centers (Royal Marsden Hospital and Saint-Andre Hospital). RESULTS: 163 patients were recruited and after propensity matching at a ratio of 2:1 n=80 patients were divided into adjuvant (n=28) and no adjuvant treatment (n=52) respectively. A comparison of adjuvant chemotherapy vs no adjuvant therapy showed that the mean overall survival was 2.67 vs 3.60 years (p=0.42), disease free survival was 2.27 vs 3.32 years (p=0.14). CONCLUSION: This study found no significant difference in survival or disease recurrence between patients who received adjuvant chemotherapy and patients who did not. There is no clear evidence to support or dismiss the use of adjuvant chemotherapy for patients who have been node positive on pre-operative MRI and node negative on histopathological staging. Further multicenter prospective randomised trials are needed to identify the appropriate treatment regime for this group of patients.
Date Issued
2017-05-11
Date Acceptance
2017-05-11
Citation
Colorectal Disease, 2017, 19 (11), pp.980-986
ISSN
1463-1318
Publisher
Wiley
Start Page
980
End Page
986
Journal / Book Title
Colorectal Disease
Volume
19
Issue
11
Copyright Statement
This is the peer reviewed version of the following article: Baird, D. L. H., Denost, Q., Simillis, C., Pellino, G., Rasheed, S., Kontovounisios, C., Tekkis, P. P. and Rullier, E. (2017), The effect of adjuvant chemotherapy on survival and recurrence after curative rectal cancer surgery in patients who are histologically node negative after neoadjuvant chemoradiotherapy. Colorectal Dis, 19: 980–986, which has been published in final form at https://dx.doi.org/10.1111/codi.13714. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Subjects
1103 Clinical Sciences
Surgery
Publication Status
Published