Othman Iskander1, Lise Courtot1, Nicolas Tabchouri1, Alice Artus1, Nicolas Michot1, Olivier Muller1, Urs Pabst-Giger2, Pascal Bourlier1, Aurore Kraemer-Bucur1, Thierry Lecomte3, Serge Guyetant4, Sophie Chapet5, Gilles Calais5, Ephrem Salamé1, Mehdi Ouaïssi6. 1. Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France. 2. Department of General-, Visceral- and Transplant Surgery, University of Münster, Münster, Germany. 3. Department of Hepatogastroenterology and Digestive Oncology, Trousseau Hospital, Tours, France. 4. Department of Histopathology, Trousseau Hospital, Tours, France. 5. Department of Radiotherapy, Bretonneau Hospital, Tours, France. 6. Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Tours, France m.ouaissi@chu-tours.fr.
Abstract
BACKGROUND/AIM: Preoperative radiochemotherapy (RCT) followed by total mesorectum excision has become the gold standard for locally advanced carcinoma of the low and middle rectum. The aim of the study is to evaluate the short and long-term outcomes of patients in complete pathological response (PR) following this treatment sequence. PATIENTS AND METHODS: One hundred and thirty patients were retrospectively included between 2005 and 2017 in an expert centre, with 3 groups formed, according to the PR: i) complete PR (absence of tumour cells on the surgical specimen ypT0N0), ii) partial PR (T or N downsizing) and iii) without PR. RESULTS: The complete PR rate was 13.1%. The complete PR group tended to develop less symptomatic fistulas compared to partial PR and without PR groups (5.8% versus 13.5% versus 18.7, respectively; p=0.607). The 5-year disease-free survival was increased for complete-PR patients (93% versus 79% versus 47%, respectively; p=0.0003) without an improvement in overall survival. CONCLUSION: Complete PR is associated with an improvement in survival without recurrence and without an improvement in the overall survival at 5 years. Copyright
BACKGROUND/AIM: Preoperative radiochemotherapy (RCT) followed by total mesorectum excision has become the gold standard for locally advanced carcinoma of the low and middle rectum. The aim of the study is to evaluate the short and long-term outcomes of patients in complete pathological response (PR) following this treatment sequence. PATIENTS AND METHODS: One hundred and thirty patients were retrospectively included between 2005 and 2017 in an expert centre, with 3 groups formed, according to the PR: i) complete PR (absence of tumour cells on the surgical specimen ypT0N0), ii) partial PR (T or N downsizing) and iii) without PR. RESULTS: The complete PR rate was 13.1%. The complete PR group tended to develop less symptomatic fistulas compared to partial PR and without PR groups (5.8% versus 13.5% versus 18.7, respectively; p=0.607). The 5-year disease-free survival was increased for complete-PRpatients (93% versus 79% versus 47%, respectively; p=0.0003) without an improvement in overall survival. CONCLUSION: Complete PR is associated with an improvement in survival without recurrence and without an improvement in the overall survival at 5 years. Copyright
Authors: Tana Machackova; Karolina Trachtova; Vladimir Prochazka; Tomas Grolich; Martina Farkasova; Lukas Fiala; Roman Sefr; Igor Kiss; Matej Skrovina; Michal Dosoudil; Ioana Berindan-Neagoe; Marek Svoboda; Ondrej Slaby; Zdenek Kala Journal: Cancer Genomics Proteomics Date: 2020 May-Jun Impact factor: 4.069