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645148.pdf (1.18 MB)

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2014-11-14

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cc-by-nc (c) García-Albéniz, X. et al., 2014
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/111525

Adjuvant therapy sparing in rectal cancer achieving complete response after chemoradiation

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Recurs relacionat

https://doi.org/10.3748/wjg.v20.i42.15820

Resum

AIM: To evaluate the long-term results of conventional chemoradiotherapy and laparoscopic mesorectal excision in rectal adenocarcinoma patients without adjuvant therapy. METHODS: Patients with biopsy-proven adenocarcinoma of the rectum staged cT3-T4 by endoscopic ultrasound or magnetic resonance imaging received neoadjuvant continuous infusion of 5-fluorouracil for five weeks and concomitant radiotherapy. Laparoscopic surgery was planned after 5-8 wk. Patients diagnosed with ypT0N0 stage cancer were not treated with adjuvant therapy according to the protocol. Patients with ypT1-2N0 or ypT3-4 or N+ were offered 5-fluorouracil-based adjuvant treatment on an individual basis. An external cohort was used as a reference for the findings. RESULTS: One hundred and seventy six patients were treated with induction chemoradiotherapy and 170 underwent total mesorectal excision. Cancer staging of ypT0N0 was achieved in 26/170 (15.3%) patients. After a median follow-up of 58.3 mo, patients with ypT0N0 had five-year disease-free and overall survival rates of 96% (95%CI: 77-99) and 100%, respectively. We provide evidence about the natural history of patients with localized rectal cancer achieving a complete response after preoperative chemoradiation. The inherent good prognosis of these patients will have implications for clinical trial design and care of patients. CONCLUSION: Withholding adjuvant chemotherapy after complete response following standard neoadjuvant chemoradiotherapy and laparoscopic mesorectal excision might be safe within an experienced multidisciplinary team.

Matèries

Càncer colorectal, Radioteràpia, Quimioteràpia del càncer, Cirurgia laparoscòpica, Estudi de casos

Matèries (anglès)

Colorectal cancer, Radiotherapy, Cancer chemotherapy, Laparoscopic surgery, Case studies

Citació

Col·leccions

Articles publicats en revistes (Fonaments Clínics)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Medicina)

Citació

GARCÍA-ALBÉNIZ, Xavier, et al. Adjuvant therapy sparing in rectal cancer achieving complete response after chemoradiation. World Journal of Gastroenterology. 2014. Vol. 20, num. 42, pags. 15820-15829. ISSN 1007-9327. [consulted: 13 of August of 2026]. Available at: https://hdl.handle.net/2445/111525

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