Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series
Abstract Aim To report long-term oncological outcomes and organ preservation rate with a chemoradiotherapy-consolidation chemotherapy (CRT-CNCT) treatment for locally advanced rectal cancer (LARC). Method Retrospective analysis of prospectively maintained database was performed. Oncological outcomes...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-11-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02816-7 |
| _version_ | 1798018157919600640 |
|---|---|
| author | Oktar Asoglu Alisina Bulut Vusal Aliyev Guglielmo Niccolò Piozzi Koray Guven Barıs Bakır Suha Goksel |
| author_facet | Oktar Asoglu Alisina Bulut Vusal Aliyev Guglielmo Niccolò Piozzi Koray Guven Barıs Bakır Suha Goksel |
| author_sort | Oktar Asoglu |
| collection | DOAJ |
| description | Abstract Aim To report long-term oncological outcomes and organ preservation rate with a chemoradiotherapy-consolidation chemotherapy (CRT-CNCT) treatment for locally advanced rectal cancer (LARC). Method Retrospective analysis of prospectively maintained database was performed. Oncological outcomes of mid-low LARC patients (n=60) were analyzed after a follow-up of 63 (50–83) months. Patients with clinical complete response (cCR) were treated with the watch-and-wait (WW) protocol. Patients who could not achieve cCR were treated with total mesorectal excision (TME) or local excision (LE). Results Thirty-nine (65%) patients who achieved cCR were treated with the WW protocol. TME was performed in 15 (25%) patients and LE was performed in 6 (10%) patients. During the follow-up period, 10 (25.6%) patients in the WW group had regrowth (RG) and 3 (7.7%) had distant metastasis (DM). Five-year overall survival (OS) and disease-free survival (DFS) were 90.1% and 71.6%, respectively, in the WW group. Five-year OS and DFS were 94.9% (95% CI: 88–100%) and 80% (95% CI: 55.2–100%), respectively, in the RG group. For all patients (n=60), 5-year TME-free DFS was 57.3% (95% CI: 44.3–70.2%) and organ preservation-adapted DFS was 77.5% (95% CI: 66.4–88.4%). For the WW group (n=39), 5-year TME-free DFS was 77.5% (95% CI: 63.2–91.8%) and organ preservation-adapted DFS was 85.0% (95% CI: 72.3–97.8%). Conclusion CRT-CNCT provides cCR as high as 2/3 of LARC patients. Regrowths, developed during follow-up, can be successfully salvaged without causing oncological disadvantage if strict surveillance is performed. |
| first_indexed | 2024-04-11T16:19:18Z |
| format | Article |
| id | doaj.art-e9e7014c84a84cec9d66eb2e17337285 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-11T16:19:18Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-e9e7014c84a84cec9d66eb2e173372852022-12-22T04:14:25ZengBMCWorld Journal of Surgical Oncology1477-78192022-11-0120111110.1186/s12957-022-02816-7Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort seriesOktar Asoglu0Alisina Bulut1Vusal Aliyev2Guglielmo Niccolò Piozzi3Koray Guven4Barıs Bakır5Suha Goksel6Bogazici Academy for Clinical SciencesBogazici Academy for Clinical SciencesBogazici Academy for Clinical SciencesDivision of Colon and Rectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of MedicineDepartment of Radiology, Acibadem Mehmet Ali Aydınlar University School of MedicineDepartment of Radiology, Istanbul University Faculty of MedicineDepartment of Pathology, Maslak Acibadem HospitalAbstract Aim To report long-term oncological outcomes and organ preservation rate with a chemoradiotherapy-consolidation chemotherapy (CRT-CNCT) treatment for locally advanced rectal cancer (LARC). Method Retrospective analysis of prospectively maintained database was performed. Oncological outcomes of mid-low LARC patients (n=60) were analyzed after a follow-up of 63 (50–83) months. Patients with clinical complete response (cCR) were treated with the watch-and-wait (WW) protocol. Patients who could not achieve cCR were treated with total mesorectal excision (TME) or local excision (LE). Results Thirty-nine (65%) patients who achieved cCR were treated with the WW protocol. TME was performed in 15 (25%) patients and LE was performed in 6 (10%) patients. During the follow-up period, 10 (25.6%) patients in the WW group had regrowth (RG) and 3 (7.7%) had distant metastasis (DM). Five-year overall survival (OS) and disease-free survival (DFS) were 90.1% and 71.6%, respectively, in the WW group. Five-year OS and DFS were 94.9% (95% CI: 88–100%) and 80% (95% CI: 55.2–100%), respectively, in the RG group. For all patients (n=60), 5-year TME-free DFS was 57.3% (95% CI: 44.3–70.2%) and organ preservation-adapted DFS was 77.5% (95% CI: 66.4–88.4%). For the WW group (n=39), 5-year TME-free DFS was 77.5% (95% CI: 63.2–91.8%) and organ preservation-adapted DFS was 85.0% (95% CI: 72.3–97.8%). Conclusion CRT-CNCT provides cCR as high as 2/3 of LARC patients. Regrowths, developed during follow-up, can be successfully salvaged without causing oncological disadvantage if strict surveillance is performed.https://doi.org/10.1186/s12957-022-02816-7Watch and waitNon-operative managementRectal cancerClinical complete responsePathological complete responseTotal neoadjuvant chemoradiotherapy |
| spellingShingle | Oktar Asoglu Alisina Bulut Vusal Aliyev Guglielmo Niccolò Piozzi Koray Guven Barıs Bakır Suha Goksel Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series World Journal of Surgical Oncology Watch and wait Non-operative management Rectal cancer Clinical complete response Pathological complete response Total neoadjuvant chemoradiotherapy |
| title | Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series |
| title_full | Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series |
| title_fullStr | Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series |
| title_full_unstemmed | Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series |
| title_short | Chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long-term oncological outcome: a single-center cohort series |
| title_sort | chemoradiation and consolidation chemotherapy for rectal cancer provides a high rate of organ preservation with a very good long term oncological outcome a single center cohort series |
| topic | Watch and wait Non-operative management Rectal cancer Clinical complete response Pathological complete response Total neoadjuvant chemoradiotherapy |
| url | https://doi.org/10.1186/s12957-022-02816-7 |
| work_keys_str_mv | AT oktarasoglu chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries AT alisinabulut chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries AT vusalaliyev chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries AT guglielmoniccolopiozzi chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries AT korayguven chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries AT barısbakır chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries AT suhagoksel chemoradiationandconsolidationchemotherapyforrectalcancerprovidesahighrateoforganpreservationwithaverygoodlongtermoncologicaloutcomeasinglecentercohortseries |