Complete Pathological Response Following Radiochemotherapy for Locally Advanced Rectal Cancer: Short and Long-term Outcome.


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 10 07 2019
revised: 19 07 2019
accepted: 22 07 2019
entrez: 15 9 2019
pubmed: 15 9 2019
medline: 27 9 2019
Statut: ppublish

Résumé

Preoperative radiochemotherapy (RCT) followed by total mesorectum excision has become the gold standard for locally advanced carcinoma of the low and middle rectum. The aim of the study is to evaluate the short and long-term outcomes of patients in complete pathological response (PR) following this treatment sequence. One hundred and thirty patients were retrospectively included between 2005 and 2017 in an expert centre, with 3 groups formed, according to the PR: i) complete PR (absence of tumour cells on the surgical specimen ypT0N0), ii) partial PR (T or N downsizing) and iii) without PR. The complete PR rate was 13.1%. The complete PR group tended to develop less symptomatic fistulas compared to partial PR and without PR groups (5.8% versus 13.5% versus 18.7, respectively; p=0.607). The 5-year disease-free survival was increased for complete-PR patients (93% versus 79% versus 47%, respectively; p=0.0003) without an improvement in overall survival. Complete PR is associated with an improvement in survival without recurrence and without an improvement in the overall survival at 5 years.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
Preoperative radiochemotherapy (RCT) followed by total mesorectum excision has become the gold standard for locally advanced carcinoma of the low and middle rectum. The aim of the study is to evaluate the short and long-term outcomes of patients in complete pathological response (PR) following this treatment sequence.
PATIENTS AND METHODS METHODS
One hundred and thirty patients were retrospectively included between 2005 and 2017 in an expert centre, with 3 groups formed, according to the PR: i) complete PR (absence of tumour cells on the surgical specimen ypT0N0), ii) partial PR (T or N downsizing) and iii) without PR.
RESULTS RESULTS
The complete PR rate was 13.1%. The complete PR group tended to develop less symptomatic fistulas compared to partial PR and without PR groups (5.8% versus 13.5% versus 18.7, respectively; p=0.607). The 5-year disease-free survival was increased for complete-PR patients (93% versus 79% versus 47%, respectively; p=0.0003) without an improvement in overall survival.
CONCLUSION CONCLUSIONS
Complete PR is associated with an improvement in survival without recurrence and without an improvement in the overall survival at 5 years.

Identifiants

pubmed: 31519622
pii: 39/9/5105
doi: 10.21873/anticanres.13705
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

5105-5113

Informations de copyright

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Othman Iskander (O)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Lise Courtot (L)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Nicolas Tabchouri (N)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Alice Artus (A)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Nicolas Michot (N)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Olivier Muller (O)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Urs Pabst-Giger (U)

Department of General-, Visceral- and Transplant Surgery, University of Münster, Münster, Germany.

Pascal Bourlier (P)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Aurore Kraemer-Bucur (A)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Thierry Lecomte (T)

Department of Hepatogastroenterology and Digestive Oncology, Trousseau Hospital, Tours, France.

Serge Guyetant (S)

Department of Histopathology, Trousseau Hospital, Tours, France.

Sophie Chapet (S)

Department of Radiotherapy, Bretonneau Hospital, Tours, France.

Gilles Calais (G)

Department of Radiotherapy, Bretonneau Hospital, Tours, France.

Ephrem Salamé (E)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France.

Mehdi Ouaïssi (M)

Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France m.ouaissi@chu-tours.fr.

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Classifications MeSH