Adjuvant Chemotherapy Use in Patients With Locally Advanced Rectal Cancer: A Single-Institution Experience

Li, Franklin; Nielsen, Gradon; Baran, Andrea; Hu, Jisheng; Wallace, Danielle; Preslar, Matthew; Fleming, Fergal J.; Temple, Larissa K.; Dunne, Richard F.; Noel, Marcus Smith; Hezel, Aram F.; Tejani, Mohamedtaki Abdulaziz

doi:10.1016/j.clcc.2020.03.008

Cited by 2 publications

(1 citation statement)

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“…In addition, things get different with the publication of the German trial (CAO/ARO/AIO-94) [4] and the European Organization for Research and Treatment of Cancer trial (EORTC 22921) [5], which laid the foundation of neoadjuvant treatment for locally advanced rectal cancer (LARC). It is reported that the compliance with AC among patients receiving neoadjuvant treatment is far lower than that receiving direct surgery mainly due to the unavoidable toxicity of AC [6,7]. But unfortunately, almost all of the published trials on neoadjuvant treatment for LARC patients have failed to show long-term survival bene ts[8-10], indicating the necessity for AC.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Zhan

Lai

et al. 2023

Preprint

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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.

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Section: Introductionmentioning

confidence: 99%