Ten-year survival after pathologic complete response in rectal adenocarcinoma.
Adenocarcinoma
/ mortality
Adult
Aged
Chemoradiotherapy, Adjuvant
/ mortality
Combined Modality Therapy
Digestive System Surgical Procedures
/ mortality
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoadjuvant Therapy
/ mortality
Neoplasm Recurrence, Local
/ mortality
Prognosis
Rectal Neoplasms
/ mortality
Retrospective Studies
Survival Rate
neoadjuvant therapy
pCR
pathologic complete response
rectal adenocarcinoma
rectal cancer
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
16
09
2020
revised:
16
09
2020
accepted:
20
09
2020
pubmed:
7
10
2020
medline:
12
1
2021
entrez:
6
10
2020
Statut:
ppublish
Résumé
Multimodal treatment is the standard of care for rectal adenocarcinoma, with a subset of patients achieving a pathologic complete response (pCR). While pCR is associated with improved overall survival (OS), long-term data on patients with pCR is limited. This is a single institution retrospective cohort study of all patients with clinical stages II/III rectal adenocarcinoma who underwent neoadjuvant chemoradiation therapy and operative resection (January 1, 2004-December 31, 2017). PCR was defined as no tumor identified in the rectum or associated lymph nodes by final pathology. Of 370 patients in this cohort, 50 had a pCR (13.5%). For pCR patients, 5-year disease-free survival (DFS) was 92%, 5-year OS was 95%. Twenty-six patients had surgery > 10 years before the study end date, of which 20 had an OS > 10 years (77%) with median OS 12.1 years and 95% alive to date (19/20). Of the 50 pCR patients, there was a single recurrence in the lung at 44.3 months after proctectomy which was surgically resected. For patients with rectal adenocarcinoma that undergo neoadjuvant chemoradiation and surgical resection, pCR is associated with excellent long-term DFS and OS. Many patients live greater than 10 years with no evidence of disease recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
Multimodal treatment is the standard of care for rectal adenocarcinoma, with a subset of patients achieving a pathologic complete response (pCR). While pCR is associated with improved overall survival (OS), long-term data on patients with pCR is limited.
METHODS
METHODS
This is a single institution retrospective cohort study of all patients with clinical stages II/III rectal adenocarcinoma who underwent neoadjuvant chemoradiation therapy and operative resection (January 1, 2004-December 31, 2017). PCR was defined as no tumor identified in the rectum or associated lymph nodes by final pathology.
RESULTS
RESULTS
Of 370 patients in this cohort, 50 had a pCR (13.5%). For pCR patients, 5-year disease-free survival (DFS) was 92%, 5-year OS was 95%. Twenty-six patients had surgery > 10 years before the study end date, of which 20 had an OS > 10 years (77%) with median OS 12.1 years and 95% alive to date (19/20). Of the 50 pCR patients, there was a single recurrence in the lung at 44.3 months after proctectomy which was surgically resected.
CONCLUSION
CONCLUSIONS
For patients with rectal adenocarcinoma that undergo neoadjuvant chemoradiation and surgical resection, pCR is associated with excellent long-term DFS and OS. Many patients live greater than 10 years with no evidence of disease recurrence.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
293-298Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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