Adjuvant chemotherapy and survival outcomes in rectal cancer patients with good response (ypT0-2N0) after neoadjuvant chemoradiotherapy and surgery: A retrospective nationwide analysis

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Title:	Adjuvant chemotherapy and survival outcomes in rectal cancer patients with good response (ypT0-2N0) after neoadjuvant chemoradiotherapy and surgery: A retrospective nationwide analysis
Authors:	Kuo, Yu-Hsuan Lin, Yun-Tzu Ho, Chung-Han Chou, Chia-Lin Cheng, Li-Chin Tsai, Chia-Jen Hong, Wei-Ju Chen, Yi-Chen Yang, Ching-Chieh
Contributors:	Chi Mei Hospital Department of Cosmetic Science, Chia Nan University of Pharmacy & Science Chi Mei Hospital Southern Taiwan University of Science & Technology Chi Mei Hospital Chung Hua University Chi Mei Hospital Department of Pharmacy, Chia Nan University of Pharmacy & Science
Keywords:	preoperative chemoradiotherapy colorectal-cancer postoperative chemoradiotherapy tumor-regression colon-cancer stage-ii radiotherapy chemoradiation benefit trial
Date:	2022
Issue Date:	2023-12-11 13:59:17 (UTC+8)
Publisher:	FRONTIERS MEDIA SA
Abstract:	Background: For rectal cancer, it remains unclear how to incorporate tumor response to neoadjuvant chemoradiotherapy (nCRT) when deciding whether to give adjuvant chemotherapy. In this study, we aim to determinate the survival benefit of adjuvant chemotherapy for rectal cancer patients with good response (ypT0-2N0) after nCRT and surgery. Methods: The study cohort included 720 rectal cancer patients who had good response (ypT0-2N0) after nCRT and surgery, who did or did not receive adjuvant chemotherapy between January 2007 and December 2017, from the Taiwan Cancer Registry and National Health Insurance Research database. The Kaplan-Meier method, log-rank tests, and Cox regression analysis were performed to investigate the effect of adjuvant chemotherapy on 5-year overall survival (OS) and disease-free survival (DFS). Results: Of 720 patients, 368 (51.1%) received adjuvant chemotherapy and 352 (48.9%) did not. Patients who received adjuvant chemotherapy were more likely to be female, younger (<= 65), with advanced clinical T (3-4)/N (1-2) classification and ypT2 classification. No significant difference in 5-year OS (p=0.681) or DFS (p=0.942) were observed by receipt of adjuvant chemotherapy or not. Multivariable analysis revealed adjuvant chemotherapy was not associated with better OS (adjusted hazard ratio [aHR], 1.03; 95% Confidence Interval [CI], 0.88-1.21) or DFS (aHR, 1.05; 95% CI, 0.89-1.24). Stratified analysis for OS and DFS found no significant protective effect in the use of adjuvant chemotherapy, even for those with advanced clinical T or N classification. Conclusion: Adjuvant chemotherapy may be omitted in rectal cancer patients with good response (ypT0-2N0) after nCRT and surgery.
Relation:	Frontiers in Oncology, v.12
Appears in Collections:	[Dept. of Cosmetic Science and institute of cosmetic science] Periodical Articles [Dept. of Pharmacy] Periodical Articles

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