Adjuvant chemotherapy after neoadjuvant chemo-radiotherapy and surgery in locally advanced rectal cancer. A systematic review of literature with a meta-analysis of randomized clinical trials

Tamburini, Emiliano; Tassinari, Davide; Ramundo, Matteo; Stefano, Alfonso De; Viola, Massimo; Romano, Carmela; Elia, Maria Teresa; Zanaletti, N.; Rudnas, Britt; Casadei-Gardini, Andrea; Delrio, Paolo; Toma, I.; Granata, Vincenza; Petrucelli, Luciana; Avallone, Antonio

doi:10.1016/j.critrevonc.2022.103627

Cited by 13 publications

(11 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has always been debated whether AC could improve the prognosis of rectal cancer [30][31][32]. Rectal cancer patients staged at pT3-4N0 treated with surgery alone are strongly recommended to receive AC to decrease the risk of recurrence [1,3].…”

Section: Discussionmentioning

confidence: 99%

Is adjuvant chemotherapy necessary for rectal cancer patients staged at ypT3-4N0?

Wang

Zhan

Lai

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose: There is substantial evidence evaluating the clinical efficacy of adjuvant chemotherapy (AC) for rectal cancer patients staged at ypN+ and ypT0-2N0, but few studies focus on those staged at ypT3-4N0. Methods: Data were collected from the Surveillance, Epidemiology and End Results (SEER) database from January 2011 to December 2015. Stabilized inverse probability of treatment weighting (sIPTW) was adopted to balance the baseline clinicopathological characteristics of ypT3-4N0 patients receiving AC or not. A risk score was established to predict the prognosis in terms of overall survival (OS) and identify who would be the beneficiary of AC. Results: A total of 920 patients staged at ypT3-4N0 were eligible, including 311 patients (33.8%) receiving AC. No significant difference was observed in OS between patients receiving AC or not before and after sIPTW (both P>0.05). The current risk score exhibited better discrimination power and overall net benefit than the 8th AJCC staging system, as well as improved prediction power. Based on the risk score, patients were divided into high- and low-risk subgroups, and only the high-risk subgroup was found to benefit from AC (P<0.05). Lastly, the risk score was validated by 100 consecutive patients from Fujian Cancer Hospital, and the advantage of AC was also confirmed in the high-risk subgroup. Conclusion: In this study, we proposed a risk-adapted and readily accessible risk score to guide the management of AC in ypT3-4N0 patients. According to the risk score, high-risk patients should be routinely recommended AC.

show abstract

Section: Discussionmentioning

confidence: 99%

Is adjuvant chemotherapy necessary for rectal cancer patients staged at ypT3-4N0?

Wang

Zhan

Lai

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Az adjuváns kezelésre vonatkozó egyértelmű kedvező hatás nem igazolt rectum tumorok esetén [8], ennek ellenére a mértékadó irányelvek javasolják [9].…”

Section: A Lokálisan Előrehaladott Tumorok Ellátásaunclassified

A rectum tumor sebészeti ellátása – Elvárható standardok

Damjanovich

2023

MaSeb

View full text Add to dashboard Cite

A rectum tumor diagnosztikája és komplex kezelése az egyik legdinamikusabban fejlődő terület az onkológia tudományának számos ága között az elmúlt néhány évtizedben. Óriási előrelépés történt a hetvenes-nyolcvanas évek eredményeihez képest, köszönhetően a sokkal pontosabb diagnosztikának, a standardizált és auditált sebészi eljárásoknak és a legújabb adjuváns/neoadjuváns kezelési módoknak és természetesen ezek jól ütemezett kombinációjának. A jelen rövid összefoglalóban azokra a sarkalatos lépésekre fogok koncentrálni, melyek elengedhetetlen alapját képezik a jó eredmények reprodukálásának. A számos szakma együttműködését kívánó tárgyi és személyi feltétel jó néhány hazai ellátó egységben elérhető. Arról kell gondoskodnunk, hogy minden beteget olyan kórházban lássunk el, ahol ezen feltételek valamennyi pontja adott, és így a beteg valóban részesülhet a mai vívmányok által nyújtott magas gyógyulási esélyben.

show abstract

“…Surgery is the most common treatment for RC, performed in 63.2% of patients [ 2 ]. Usually, surgical treatment is an upfront treatment for low-risk patients (T2 stage or lowest), while for high-risk patients this approach follows a neoadjuvant treatment (radiotherapy and adjuvant chemotherapy, as a long-course or short-course treatment) [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. After neoadjuvant treatment, the type of surgical approach chosen aims to achieve maximum residual function with the lowest risk of recurrence, according to the location of the tumor and the degree of invasion of the pelvic floor and sphincter system [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Imaging plays a key role not only in the pre-operative phase, but also in the post-treatment period in assessing the response to neoadjuvant chemoradiotherapy (nCRT), postoperative complications, and disease recurrence [ 10 , 11 , 12 ]. Post-surgical anatomy could be difficult to interpret, and the radiologist should be familiar with the main surgical procedures and any associated pathological findings [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Muzio

Fusco

Cutolo

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

Rectal cancer (RC) is one of the deadliest malignancies worldwide. Surgery is the most common treatment for RC, performed in 63.2% of patients. The type of surgical approach chosen aims to achieve maximum residual function with the lowest risk of recurrence. The selection is made by a multidisciplinary team that assesses the characteristics of the patient and the tumor. Total mesorectal excision (TME), including both low anterior resection (LAR) and abdominoperineal resection (APR), is still the standard of care for RC. Radical surgery is burdened by a 31% rate of major complications (Clavien–Dindo grade 3–4), such as anastomotic leaks and a risk of a permanent stoma. In recent years, less-invasive techniques, such as local excision, have been tested. These additional procedures could mitigate the morbidity of rectal resection, while providing acceptable oncologic results. The “watch and wait” approach is not a globally accepted model of care but encouraging results on selected groups of patients make it a promising strategy. In this plethora of treatments, the radiologist is called upon to distinguish a physiological from a pathological postoperative finding. The aim of this narrative review is to identify the main post-surgical complications and the most effective imaging techniques.

show abstract

Adjuvant chemotherapy after neoadjuvant chemo-radiotherapy and surgery in locally advanced rectal cancer. A systematic review of literature with a meta-analysis of randomized clinical trials

Cited by 13 publications

References 29 publications

Is adjuvant chemotherapy necessary for rectal cancer patients staged at ypT3-4N0?

Is adjuvant chemotherapy necessary for rectal cancer patients staged at ypT3-4N0?

A rectum tumor sebészeti ellátása – Elvárható standardok

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Contact Info

Product

Resources

About