García-Albéniz, XavierGallego, RosaHofhteinz, Ralf DieterFernández Esparrach, GlòriaAyuso Colella, Juan RamónBombí, Josep AntoniConill, CarlesCuatrecasas Freixas, MiriamDelgado Rivilla, SalvadoraGinès i Gibert, M. ÀngelsMiquel Morera, RosaPagès Llinàs, M. (Mario)Pineda, EstelaPereira, María VerónicaSosa, AarónReig Torras, OscarVictoria, IvánFeliz, LuisLacy Fortuny, Antonio Ma. deCastells Garangou, AntoniBurkholder, IrisHochhaus, AndreasMaurel Santasusana, Joan2017-05-252017-05-252014-11-141007-9327https://hdl.handle.net/2445/111525AIM: 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.11 p.application/pdfengcc-by-nc (c) García-Albéniz, X. et al., 2014http://creativecommons.org/licenses/by-nc/3.0/esCàncer colorectalRadioteràpiaQuimioteràpia del càncerCirurgia laparoscòpicaEstudi de casosColorectal cancerRadiotherapyCancer chemotherapyLaparoscopic surgeryCase studiesinfo:eu-repo/semantics/article6451482017-05-25info:eu-repo/semantics/openAccess25400468