Outcomes ofpreoperative chemoradiotherapy followed bysurgery inpatients withunresectable locally advanced sigmoid colon cancer
10.1186/s40880-016-0126-y
- Author:
BoQiu
1
;
PeiRongDing
;
LingCai
;
WeiWeiXiao
;
ZhiFanZeng
;
GongChen
;
ZhenHaiLu
;
LiRenLi
;
XiaoJunWu
;
Mirimanoff RENEOLIVIER
;
ZhiZhongPan
;
RuiHuaXu
;
YuanHongGao
Author Information
1. State Key Laboratory of Oncology in South China
- Keywords:
Unresectable locally advanced sigmoid colon cancer;
Neoadjuvant chemoradiotherapy;
R0 resection;
Down-staging;
Organ preservation
- From:Chinese Journal of Cancer
2016;35(10):535-545
- CountryChina
- Language:Chinese
-
Abstract:
Background:Complete resection of locally advanced sigmoid colon cancer (LASCC) is sometimes diffcult. Patients with LASCC have a dismal prognosis and poor quality of life, which has encouraged the evaluation of alternative multimodality treatments. This prospective study aimed to assess the feasibility and effcacy of neoadjuvant chemora?diotherapy (neoCRT) followed by surgery as treatment of selected patients with unresectable LASCC.
Methods:We studied the patients with unresectable LASCC who received neoCRT followed by surgery between October 2010 and December 2012. The neoadjuvant regimen consisted of external?beam radiotherapy to 50Gy and capecitabine?based chemotherapy every 3weeks. Surgery was scheduled 6–8weeks after radiotherapy.
Results:Twenty?one patients were included in this study. The median follow?up was 42months (range, 17–57months). All patients completed neoCRT and surgery. Resection with microscopically negative margins (R0 resection) was achieved in 20 patients (95.2%). Pathologic complete response was observed in 8 patients (38.1%). Multivisceral resection was necessary in only 7 patients (33.3%). Two patients (9.5%) experienced grade 2 postopera?tive complications. No patients died within 30days after surgery. For 18 patients with pathologic M0 (ypM0) disease, the cumulative probability of 3?year local recurrence?free survival, disease?free survival and overall survival was 100.0%, 88.9% and 100.0%, respectively. For all 21 patients, the cumulative probability of 3?year overall survival was 95.2% and bladder function was well preserved.
Conclusion:For patients with unresectable LASCC, preoperative chemoradiotherapy and surgery can be performed safely and may result in an increased survival rate.
