INTRODUCTION: Adjuvant chemotherapy for locally advanced rectal cancer is associated with improved overall survival. However, recent evidence from randomized trials showed a compliance rate of 43 to 73%, which may affect efficacy. The aim of this multicenter retrospective analysis was to investigate the compliance rate to adjuvant treatment for patients who underwent rectal surgery for cancer. METHODS: Patients who underwent surgery with curative intent for rectal cancer in six Italian colorectal centers between January 2013 and December 2017 were retrospectively reviewed. Exclusion criteria were age less than 18 years, palliative or emergency surgery, and stage IV disease. Parameters of interest were patients' characteristics, preoperative tumor stage, neo-adjuvant chemoradiation therapy, intra-operative and postoperative outcomes. Although the participating centers referred to the same treatment guidelines for treatment, the chemotherapy regiment was not standardized across the institutions. Reasons for not starting adjuvant chemotherapy when indicated, interruption, and modification of drug regimen were collected to investigate compliance. RESULTS: A total of 572 patients were included in the analysis. Two hundred and fifty-two (44.1%) patients received neo-adjuvant chemoradiation therapy. All patients underwent high anterior rectal resection, low anterior rectal resection, or Miles' procedure. Of 399 patients with an indication to adjuvant chemotherapy, 176 (44.1%) completed the treatment as planned. Compliance for patients who started chemotherapy was 56% (95% CI 50.4-61.6%). Sixty-six patients interrupted the treatment, 76 patients significantly reduced the drug dose, and 41 patients had to switch to other therapeutic regimens. CONCLUSIONS: The present multicenter investigation reports a low compliance rate to adjuvant chemotherapy after rectal resection for cancer. Multidisciplinary teams should focus on future effort to improve compliance for these patients.
INTRODUCTION: Adjuvant chemotherapy for locally advanced rectal cancer is associated with improved overall survival. However, recent evidence from randomized trials showed a compliance rate of 43 to 73%, which may affect efficacy. The aim of this multicenter retrospective analysis was to investigate the compliance rate to adjuvant treatment for patients who underwent rectal surgery for cancer. METHODS:Patients who underwent surgery with curative intent for rectal cancer in six Italian colorectal centers between January 2013 and December 2017 were retrospectively reviewed. Exclusion criteria were age less than 18 years, palliative or emergency surgery, and stage IV disease. Parameters of interest were patients' characteristics, preoperative tumor stage, neo-adjuvant chemoradiation therapy, intra-operative and postoperative outcomes. Although the participating centers referred to the same treatment guidelines for treatment, the chemotherapy regiment was not standardized across the institutions. Reasons for not starting adjuvant chemotherapy when indicated, interruption, and modification of drug regimen were collected to investigate compliance. RESULTS: A total of 572 patients were included in the analysis. Two hundred and fifty-two (44.1%) patients received neo-adjuvant chemoradiation therapy. All patients underwent high anterior rectal resection, low anterior rectal resection, or Miles' procedure. Of 399 patients with an indication to adjuvant chemotherapy, 176 (44.1%) completed the treatment as planned. Compliance for patients who started chemotherapy was 56% (95% CI 50.4-61.6%). Sixty-six patients interrupted the treatment, 76 patients significantly reduced the drug dose, and 41 patients had to switch to other therapeutic regimens. CONCLUSIONS: The present multicenter investigation reports a low compliance rate to adjuvant chemotherapy after rectal resection for cancer. Multidisciplinary teams should focus on future effort to improve compliance for these patients.
Authors: A J Breugom; W van Gijn; E W Muller; Å Berglund; C B M van den Broek; T Fokstuen; H Gelderblom; E Kapiteijn; J W H Leer; C A M Marijnen; H Martijn; E Meershoek-Klein Kranenbarg; I D Nagtegaal; L Påhlman; C J A Punt; H Putter; A G H Roodvoets; H J T Rutten; W H Steup; B Glimelius; C J H van de Velde Journal: Ann Oncol Date: 2014-12-05 Impact factor: 32.976
Authors: Zhifei Sun; Brian Gilmore; Mohamed A Adam; Jina Kim; Shiao-Wen D Hsu; John Migaly; Christopher R Mantyh Journal: Dis Colon Rectum Date: 2017-10 Impact factor: 4.585
Authors: R Glynne-Jones; N Counsell; P Quirke; N Mortensen; A Maraveyas; H M Meadows; J Ledermann; D Sebag-Montefiore Journal: Ann Oncol Date: 2014-04-08 Impact factor: 32.976
Authors: Mauro Podda; Patricia Sylla; Gianluca Baiocchi; Michel Adamina; Vanni Agnoletti; Ferdinando Agresta; Luca Ansaloni; Alberto Arezzo; Nicola Avenia; Walter Biffl; Antonio Biondi; Simona Bui; Fabio C Campanile; Paolo Carcoforo; Claudia Commisso; Antonio Crucitti; Nicola De'Angelis; Gian Luigi De'Angelis; Massimo De Filippo; Belinda De Simone; Salomone Di Saverio; Giorgio Ercolani; Gustavo P Fraga; Francesco Gabrielli; Federica Gaiani; Mario Guerrieri; Angelo Guttadauro; Yoram Kluger; Ari K Leppaniemi; Andrea Loffredo; Tiziana Meschi; Ernest E Moore; Monica Ortenzi; Francesco Pata; Dario Parini; Adolfo Pisanu; Gilberto Poggioli; Andrea Polistena; Alessandro Puzziello; Fabio Rondelli; Massimo Sartelli; Neil Smart; Michael E Sugrue; Patricia Tejedor; Marco Vacante; Federico Coccolini; Justin Davies; Fausto Catena Journal: World J Emerg Surg Date: 2021-07-02 Impact factor: 5.469