AI Article Synopsis
- Research investigates if adjuvant chemotherapy (ACT) benefits patients with locally advanced rectal cancer (LARC) who achieved pathologic complete response (pCR) after neoadjuvant chemoradiotherapy.
- Results from analyzing 1041 pCR patients indicated no significant difference in 3-year survival rates across those who received ACT versus those who didn't.
- The study concludes that ACT does not improve survival for pCR LARC patients and is therefore unnecessary after successful neoadjuvant treatment.
Article Abstract
Background: For patients with locally advanced rectal cancer (LARC), it is unclear whether neoadjuvant chemoradiotherapy-induced pathologic complete response (pCR) individuals would further benefit from adjuvant chemotherapy (ACT).
Methods: The pCR individuals who received different ACT cycles were paired by propensity score matching. Overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated by Kaplan-Meier and log-rank test.
Results: In total, 1041 pCR individuals were identified from 5567 LARC cases. Specifically, 303 pCR cases had no ACT treatment, and 738 pCR patients received fluoropyrimidine-based ACT (median, 4 cycles) treatment. After 1:3 propensity score matching, 297 cases without ACT treatment were matched to 712 cases who received ACT treatment. Kaplan-Meier analysis showed that pCR individuals treated with or without ACT had the similar 3-year outcome (OS, DFS, LRFS and DMFS) (all P > 0.05). Moreover, the pCR patients received different ACT cycle(s) (0 vs. 1-4 cycles, 0 vs. ≥5 cycles) had comparable 3-year OS, DFS, LRFS and DMFS (all P > 0.05). In stratified analysis, ACT treatment did not improve 3-year survival (OS, DFS, LRFS and DMFS) for the baseline high-risk (cT3-4/cN1-2) subgroup patients (all P > 0.05).
Conclusion: ACT, which did not improve survival, is unnecessary to neoadjuvant treatment-induced pCR LARC patients.
Trial Registration: 2019ZSLYEC-136 (24-6-2019).
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553967 | PMC |
| http://dx.doi.org/10.1038/s41416-020-0989-1 | DOI Listing |
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