Neoadjuvant Treatment in Upper Rectal Cancer Does Not Improve Oncologic Outcomes But Increases Postoperative Morbidity

Autor: Ephrem Salamé, Gilles Manceau, Arnaud Alves, A. Frontali, Yves Panis, Bruno Heyd, Zaher Lakkis, Y. Eid, Nicolas Tabchouri, Mehdi Ouaissi, Sophie Chapet, Mehdi Karoui, Thierry Lecomte, Gilles Calais
Rok vydání: 2020
Předmět:
Zdroj: Anticancer Research. 40:3579-3587
ISSN: 1791-7530
0250-7005
DOI: 10.21873/anticanres.14348
Popis: Neoadjuvant chemoradiation/radiation therapy in locally advanced (LA) upper rectal adenocarcinoma management remains unclear. The aim of this study was to compare outcomes between neoadjuvant chemoradiation therapy (CRT) and upfront surgery (US).A total of 127 patients were retrospectively included from 5 centers (79 treated with US and 48 with CRT). CRT and US groups were compared in terms of postoperative complications and long-term oncological and functional results.Total mesorectal excision (TME) was more frequent in CRT (58% vs. 20% in US, p0.001). CRT was associated with more overall and severe postoperative complications (60% vs. 30%, p0.001 and 17% vs. 1%, p=0.002, respectively), and was the only risk factor [OR=18.8 (2.2-160.2), p=0.007]. Five-year overall survival and 5-year recurrence-free survival were similar between CRT and US (96% vs. 91% p=0.256 and 85.4% vs. 85%, p=0.495). The functional results were similar between the two groups.CRT did not improve long-term oncological outcomes in patients with LA upper rectal adenocarcinoma, but increased postoperative complications compared with US.
Databáze: OpenAIRE