Is there a role for adjuvant chemotherapy in pathological complete response rectal cancer tumors following neoadjuvant chemoradiotherapy?

Ravit Geva, Eran Itzkovich, Sivan Shamai, Einat Shacham-Shmueli, Viacheslav Soyfer, Joseph M. Klausner, Hagit Tulchinsky

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate the contribution of neoadjuvant chemotherapy in rectal cancer patients with pathological complete response (pCR). Methods: Data were collected on all consecutive locally advanced rectal cancer patients treated with neoadjuvant chemotherapy and later resected in our institution between 2001 and 2013. Surgery was performed by a single proctology team, and tumor specimens were evaluated by the hospital pathologists. Results: The medical records of 260 patients were analyzed, and 54 patients of those patients were found to have achieved pCR (20.8 %). Two of those patients were lost to follow-up. Thirty-five of the 54 pCR patients received adjuvant chemotherapy (Group A) and 17 did not (Group B). With the sole exception of the Group A patients being younger than the Group B patients (60.9 ± 11.9 vs. 68.7 ± 10.8 years, respectively, p = 0.0272), all other evaluated parameters were identical between the two groups. There was no advantage for the administration of adjuvant chemotherapy for disease-free survival (DFS) and overall survival (OS). Conclusions: Adjuvant chemotherapy played no part in disease-free survival and OS of patients with rectal cancer who had been treated with neoadjuvant chemotherapy and achieved pCR. Our findings indicate a tendency for adjuvant chemotherapy to be administered to younger rectal cancer patients. A randomized trial should be conducted to resolve the question of whether they derive any benefit from it.

Original languageEnglish
Pages (from-to)1489-1494
Number of pages6
JournalJournal of Cancer Research and Clinical Oncology
Volume140
Issue number9
DOIs
StatePublished - Sep 2014

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