Abstract
Aim: This study aimed to evaluate the usefulness of oral adjuvant chemotherapy (OAC) for T3 lower rectal cancers without lateral lymph node metastasis.Methods: Between 2010 and 2014, 110 patients with T3 lower rectal cancer without lateral lymph node metastasis, 80 years of age or younger, who underwent curative resection at four Jikei University Hospitals were enrolled in this retrospective study. Of these, 94 patients underwent neither preoperative chemoradiotherapy (CRT) nor intensive chemotherapy after surgery: 47 patients who did not receive OAC for a pathological diagnosis of stage II cancer and 47 patients who did receive OAC for a pathological diagnosis of stage III cancer. The remaining 16 patients received intensive oxaliplatin-based combination chemotherapy after surgery without preoperative CRT.Results: The 5-year disease-free survival (DFS) of the 47 patients in stage II was 82.6%, whereas that of the 63 patients in stage III was 63.1% (p=0.033). The 5-year DFS of the 16 patients who received intensive chemotherapy after surgery was 81.3%, which was similar to the DFS of stage II patients, whereas that of the 47 patients with OAC alone was 58.2% (p=0.048).Conclusion: Intensive oxaliplatin-based combination chemotherapy after surgery was better for 5-year DFS than OAC among stage III patients. OAC is not suitable as adjuvant chemotherapy for patients with stage III lower rectal cancer even if no lateral lymph node metastasis is detected.
The Effectiveness of Machine Learning in Predicting Lateral Lymph Node Metastasis From Lower Rectal Cancer: A Single Center Development and Validation Study
