BACKGROUND: The aim of this study was to evaluate the effect of a longer interval between long-course neoadjuvant chemoradiotherapy and surgery on surgical and oncologic outcome. METHODS: A total of 233 consecutive patients with clinical stage II and III rectal cancer were divided into 2 groups according to the neoadjuvant-surgery interval: short-interval group (≤ 7 weeks, n = 111), and long-interval group (>7 weeks, n = 122). Data on neoadjuvant-surgery interval, operative time, perioperative complications, final pathology, disease recurrence, and mortality were prospectively collected and analyzed. RESULTS: The two groups were comparable in terms of demographics, tumor, and treatment characteristics. Operative time and perioperative complications were not influenced by a longer interval. Patients in the long-interval group had a significantly higher pathologic complete response (pCR) rate (27.1% vs. 15.3%, P = 0.029), and a decreased rate of circumferential resection margin involvement (1.6% vs. 8.1%, P = 0.020). After a median follow-up of 42 months (range 6-90 months), the 3-year local recurrence rate was 12.9% in the short-interval group versus 4.8% in the long-interval group (P = 0.025). CONCLUSIONS: A neoadjuvant-surgery interval >7 weeks is safe and is associated with a higher rate of pCR and R0 resection, and decreased local recurrence.
BACKGROUND: The aim of this study was to evaluate the effect of a longer interval between long-course neoadjuvant chemoradiotherapy and surgery on surgical and oncologic outcome. METHODS: A total of 233 consecutive patients with clinical stage II and III rectal cancer were divided into 2 groups according to the neoadjuvant-surgery interval: short-interval group (≤ 7 weeks, n = 111), and long-interval group (>7 weeks, n = 122). Data on neoadjuvant-surgery interval, operative time, perioperative complications, final pathology, disease recurrence, and mortality were prospectively collected and analyzed. RESULTS: The two groups were comparable in terms of demographics, tumor, and treatment characteristics. Operative time and perioperative complications were not influenced by a longer interval. Patients in the long-interval group had a significantly higher pathologic complete response (pCR) rate (27.1% vs. 15.3%, P = 0.029), and a decreased rate of circumferential resection margin involvement (1.6% vs. 8.1%, P = 0.020). After a median follow-up of 42 months (range 6-90 months), the 3-year local recurrence rate was 12.9% in the short-interval group versus 4.8% in the long-interval group (P = 0.025). CONCLUSIONS: A neoadjuvant-surgery interval >7 weeks is safe and is associated with a higher rate of pCR and R0 resection, and decreased local recurrence.
Authors: Julio Garcia-Aguilar; Oliver S Chow; David D Smith; Jorge E Marcet; Peter A Cataldo; Madhulika G Varma; Anjali S Kumar; Samuel Oommen; Theodore Coutsoftides; Steven R Hunt; Michael J Stamos; Charles A Ternent; Daniel O Herzig; Alessandro Fichera; Blase N Polite; David W Dietz; Sujata Patil; Karin Avila Journal: Lancet Oncol Date: 2015-07-14 Impact factor: 41.316
Authors: H Salvador-Rosés; S López-Ben; M Casellas-Robert; P Planellas; N Gómez-Romeu; R Farrés; E Ramos; A Codina-Cazador; J Figueras Journal: Clin Transl Oncol Date: 2017-12-22 Impact factor: 3.405
Authors: Oliver S Chow; Deborah Kuk; Metin Keskin; J Joshua Smith; Niedzica Camacho; Raphael Pelossof; Chin-Tung Chen; Zhenbin Chen; Karin Avila; Martin R Weiser; Michael F Berger; Sujata Patil; Emily Bergsland; Julio Garcia-Aguilar Journal: Ann Surg Oncol Date: 2016-03-28 Impact factor: 5.344