scholarly journals Adjuvant chemotherapy for locally advanced rectal cancer in elderly patients after neoadjuvant chemoradiotherapy and surgery

Medicine ◽  
2020 ◽  
Vol 99 (4) ◽  
pp. e18835 ◽  
Author(s):  
Quanquan Sun ◽  
Tongxin Liu ◽  
Peng Liu ◽  
Ke Lu ◽  
Na Zhang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Elderly Patients ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

What determines adjuvant chemotherapy use after neoadjuvant chemoradiotherapy for rectal cancer?

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 546-546 ◽  
Author(s):  
George J. Chang ◽  
Chung-Yuan Hu ◽  
Y. Nancy You ◽  
Cathy Eng ◽  
Miguel A. Rodriguez-Bigas ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Treatment Guidelines ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Radical Resection ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Clinicopathologic Characteristics ◽  
Treatment Standard

546 Background: The treatment standard for rectal cancer patients after neoadjuvant chemoradiotherapy (CXRT) and radical resection includes adjuvant chemotherapy (CT). The purpose of this study was to evaluate patient demographic and clinicopathologic characteristics in relation to adjuvant CT use. Methods: A retrospective cohort study of patients ≥ 65 years old with rectal cancer treated by neoadjuvant CXRT and radical resection in the Surveillance, Epidemiology, and End Results-linked Medicare database (1998-2007, Medicare Part A/B only) was performed. Multivariate logistic regression was used to assess CT utilization in relation to patient, tumor and treatment response characteristics. Results: Among 1344 patients who met study criteria, 748 (55.6%) received adjuvant CT with 5-fluorouracil (FU) including 189 (25.3%) who also received oxaliplatin (Ox). ypStage was the strongest determinant of both any post-operative CT (43.1% stage I, 51.3% stage II, 73.4% stage III). Other associated factors included age, comorbidity, marital status and surgery type. In addition, age, socioeconomic status, and grade were associated with Ox use. These effects persisted even after exclusion of patients with comorbidities. Conclusions: Although standard treatment guidelines for locally advanced rectal cancer include postoperative CT for all patients after neoadjuvant CXRT and radical resection, nearly 1 in 2 patients failed to receive adjuvant CT. Despite the absence of established evidence, treatment decisions appear to be influenced by the findings at surgical pathology. [Table: see text]

Outcomes of elderly patients receiving neoadjuvant chemoradiation and adjuvant chemotherapy for locally advanced rectal cancer in a retrospective cohort.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e15145-e15145
Author(s):  
Pablo Reguera Puertas ◽  
Vanessa Pachón Olmos ◽  
Reyes Ferreiro Monteagudo ◽  
Federico Longo ◽  
Carmen Guillen ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Elderly Patients ◽  
Retrospective Cohort ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Neoadjuvant Chemoradiation

Which is the better prognostic factor in rectal cancer patients who received neoadjuvant chemoradiotherapy: cTNM stage vs. ypTNM stage?

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 693-693
Author(s):  
HyungJin Kim ◽  
Gun Kim ◽  
Ri Na Yoo ◽  
Bong-Hyeon Kye ◽  
Hyeon-Min Cho
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Complete Remission ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Staging System ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Stage I

693 Background: Neoadjuvant chemoradiotherapy (nCRT) in rectal cancer is widely applied in patients with cTNM II and III stage. However, it is still obscure which staging system, either clinical (c) or pathologic (yp), influences in prognosis. This study aims to evaluate the current staging system predicting prognosis in the locally advanced rectal cancer patients. Methods: Among 221 patients who were diagnosed with rectal cancer and underwent curative resection from January 2009 to February 2013, 141 patients who received nCRT were included. The ypTNM stage was categorized: complete remission and stage I to ypI. Results: Mean follow-up period was 36.3 ± 15.1 months. Disease-free survival (DFS) was not associated with age, sex, Anesthesiologists classification, types of operative procedure, tumor cell differentiation, tumor location, tumor infiltration, preoperative CEA level, adjuvant chemotherapy. cTNM stage did not demonstrate any correlation with DFS (cII % vs cIII %, P = 0.266). However, DFS did exhibit statistically significant association with postoperative CEA level (P < 0.001) and ypTNM stage. 3-year DFS rate for each categorized stage is as followed – ypI, 87.9%; ypII, 67.8%; ypIII, 53.3% (ypI vs. ypII P = 0.009, ypI vs. ypIII P < 0.001, ypII vs. ypIII P= 0.185). Conclusions: Oncologic outcome of the patients with locally advanced rectal cancer is associated with pathologic TNM stage. Based on our results, we think that adjuvant chemotherapy given to patients with complete remission or pathologic stage I may be reconsidered.

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