INTRODUCTION: Patients with stage II/III rectal cancers are treated with neoadjuvant chemoradiation and surgical resection followed by adjuvant chemotherapy (CT) per practice guidelines. It is unclear whether adjuvant CT provides survival benefit, and the purpose of this study was to measure outcomes in patients who did and did not receive adjuvant CT. MATERIALS AND METHODS: We used a prospectively collected database for patients treated at The Ohio State University, and analyzed overall survival (OS), time to recurrence, patient characteristics, tumor features, and treatments. Survival curves were estimated using Kaplan-Meier method and compared by the log-rank test. Age was compared using the Wilcoxon test, and other categorical variables were compared using the χ or Fisher exact test. RESULTS: Between August 2005 and July 2011, 110 patients were identified and 71 patients had received adjuvant CT. There was no significant difference in sex, race, pathologic tumor stage, and pathologic complete response between the 2 patient groups. Although patient characteristics showed a difference in age (median age 54.3 vs. 62 y, P=0.01) and advanced pathologic nodal status (43% vs. 19%, P=0.02), there was a significant difference in OS. Median OS was 72.6 months with CT versus 36.4 months without CT (P=0.0003). Median time to recurrence has not yet been reached. CONCLUSIONS: In this retrospective analysis, adjuvant CT was associated with a longer OS despite more advanced pathologic nodal staging. Prospective randomized studies are warranted to determine whether adjuvant CT provides a survival benefit for patients across the spectrum of stage II and III rectal cancer.
INTRODUCTION:Patients with stage II/III rectal cancers are treated with neoadjuvant chemoradiation and surgical resection followed by adjuvant chemotherapy (CT) per practice guidelines. It is unclear whether adjuvant CT provides survival benefit, and the purpose of this study was to measure outcomes in patients who did and did not receive adjuvant CT. MATERIALS AND METHODS: We used a prospectively collected database for patientstreated atThe Ohio State University, and analyzed overall survival (OS), time to recurrence, patient characteristics, tumor features, and treatments. Survival curves were estimated using Kaplan-Meier method and compared by the log-rank test. Age was compared using the Wilcoxon test, and other categorical variables were compared using the χ or Fisher exacttest. RESULTS: Between August 2005 and July 2011, 110 patients were identified and 71 patients had received adjuvant CT. There was no significant difference in sex, race, pathologic tumor stage, and pathologic complete response between the 2 patient groups. Although patient characteristics showed a difference in age (median age 54.3 vs. 62 y, P=0.01) and advanced pathologic nodal status (43% vs. 19%, P=0.02), there was a significant difference in OS. Median OS was 72.6 months with CT versus 36.4 months without CT (P=0.0003). Median time to recurrence has not yet been reached. CONCLUSIONS: In this retrospective analysis, adjuvant CT was associated with a longer OS despite more advanced pathologic nodal staging. Prospective randomized studies are warranted to determine whether adjuvant CT provides a survival benefit for patients across the spectrum of stage II and III rectal cancer.
Authors: Rolf Sauer; Heinz Becker; Werner Hohenberger; Claus Rödel; Christian Wittekind; Rainer Fietkau; Peter Martus; Jörg Tschmelitsch; Eva Hager; Clemens F Hess; Johann-H Karstens; Torsten Liersch; Heinz Schmidberger; Rudolf Raab Journal: N Engl J Med Date: 2004-10-21 Impact factor: 91.245
Authors: Ralf-Dieter Hofheinz; Frederik Wenz; Stefan Post; Axel Matzdorff; Stephan Laechelt; Jörg T Hartmann; Lothar Müller; Hartmut Link; Markus Moehler; Erika Kettner; Elisabeth Fritz; Udo Hieber; Hans Walter Lindemann; Martina Grunewald; Stephan Kremers; Christian Constantin; Matthias Hipp; Gernot Hartung; Deniz Gencer; Peter Kienle; Iris Burkholder; Andreas Hochhaus Journal: Lancet Oncol Date: 2012-04-13 Impact factor: 41.316
Authors: J Philip Kuebler; H Samuel Wieand; Michael J O'Connell; Roy E Smith; Linda H Colangelo; Greg Yothers; Nicholas J Petrelli; Michael P Findlay; Thomas E Seay; James N Atkins; John L Zapas; J Wendall Goodwin; Louis Fehrenbacher; Ramesh K Ramanathan; Barbara A Conley; Patrick J Flynn; Gamini Soori; Lauren K Colman; Edward A Levine; Keith S Lanier; Norman Wolmark Journal: J Clin Oncol Date: 2007-04-30 Impact factor: 44.544
Authors: M J O'Connell; J A Martenson; H S Wieand; J E Krook; J S Macdonald; D G Haller; R J Mayer; L L Gunderson; T A Rich Journal: N Engl J Med Date: 1994-08-25 Impact factor: 91.245
Authors: J E Krook; C G Moertel; L L Gunderson; H S Wieand; R T Collins; R W Beart; T P Kubista; M A Poon; W C Meyers; J A Mailliard Journal: N Engl J Med Date: 1991-03-14 Impact factor: 91.245
Authors: Benjamin Garlipp; Henry Ptok; Frank Benedix; Ronny Otto; Felix Popp; Karsten Ridwelski; Ingo Gastinger; Christoph Benckert; Hans Lippert; Christiane Bruns Journal: Langenbecks Arch Surg Date: 2016-11-09 Impact factor: 3.445