Impact of interval between noeadjuvant chemoradiotherapy and surgery on short and long-term outcomes of patients with rectal cancer
10.3760/cma.j.issn.0253-3766.2018.11.007
- VernacularTitle: 中晚期直肠癌新辅助放化疗后的手术时机研究
- Author:
Jiansheng ZHANG
1
;
Tao WANG
2
;
Haipeng DU
1
;
Ling WU
1
Author Information
1. General Surgery Department, Baodi Hospital, Tianjin 301800, China
2. Anorectal Surgery Department, Tianjin Unin Medical Center, Tianjin 300201, China
- Publication Type:Clinical Trail
- Keywords:
Rectal neoplasms;
Neoadjuvant chemoradiation;
Surgery;
Complete remission;
Recurrence
- From:
Chinese Journal of Oncology
2018;40(11):833-836
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the best surgical timing after neoadjuvant chemoradiation for advanced rectal cancer patients.
Methods:According to the time interval between neoadjuvant chemoradiation and surgery, 117 patients with advanced rectal cancer were divided into short interval group (≤7 weeks, n=54) and long interval group (>7 weeks, n=64). The endpoints included postoperative pathology, short-term efficacy, tumor recurrence and patient survival between the two groups.
Results:There were 8 cases PCR in short interval group and 20 cases in long interval group(P=0.415). There were 23 cases of T downgrade in short interval group and 40 cases in the long interval group, which has significant difference (P=0.039). There were 21 cases of N downgrade in short interval group and 38 cases in long interval group, which has significant different (P=0.033). The short-term group was effective in 28 cases, stable in 20 cases, and progressed in 5 cases. In short term efficacy comparison, the cases of complete response, stable disease and progressive disease in short interval group was 28 cases, 20 and 5, long interval group was 47 cases, 14 cases and 3 cases, which has no significant difference(P=0.068). The 3-year local recurrence rate of short interval group and long interval group was 17.0% and 4.7%, respectively, and the difference was statistically significant(P=0.029). The incidence of recurrence in 3 years of short interval group and long interval group was 64.2% and 79.7%, respectively, and the difference was not significant (P=0.061). The highest PCR rate was reached in the 10th and 11th week after neoadjuvant chemoradiotherapy. Of the 12 and 8 patients who underwent surgery, 3 (25.0%) and 2 (25.0%) achieved PCR, respectively.
Conclusion:PCR and local recurrence rate might be improved by time interval between neoadjuvant chemoradiation and surgery was more than 7 weeks.
