Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer
Background: Total neoadjuvant therapy (TNT) is an accepted approach for the management of locally advanced rectal cancer (LARC) and is associated with a decreased risk of development of metastatic disease compared to standard neoadjuvant therapy. However, questions remain regarding surgical outcomes...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Surgery Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845024000174 |
| _version_ | 1797226664774598656 |
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| author | I-Chia Liu, MD Susan Gearhart, MD MEd Suqi Ke, MS Chen Hu, PhD MS Haniee Chung, MD Jonathan Efron, MD Alodia Gabre-Kidan, MD MPH Peter Najjar, MD MBA Chady Atallah, MD Bashar Safar, MD Eric S. Christenson, MD Nilofer S. Azad, MD Valerie Lee, MD Atif Zaheer, MD Jacqueline E. Birkness-Gartman, MD Abhinav V. Reddy, MD Amol K. Narang, MD Jeffrey Meyer, MD MS |
| author_facet | I-Chia Liu, MD Susan Gearhart, MD MEd Suqi Ke, MS Chen Hu, PhD MS Haniee Chung, MD Jonathan Efron, MD Alodia Gabre-Kidan, MD MPH Peter Najjar, MD MBA Chady Atallah, MD Bashar Safar, MD Eric S. Christenson, MD Nilofer S. Azad, MD Valerie Lee, MD Atif Zaheer, MD Jacqueline E. Birkness-Gartman, MD Abhinav V. Reddy, MD Amol K. Narang, MD Jeffrey Meyer, MD MS |
| author_sort | I-Chia Liu, MD |
| collection | DOAJ |
| description | Background: Total neoadjuvant therapy (TNT) is an accepted approach for the management of locally advanced rectal cancer (LARC) and is associated with a decreased risk of development of metastatic disease compared to standard neoadjuvant therapy. However, questions remain regarding surgical outcomes and local control in patients who proceed to surgery, particularly when radiation is given first in the neoadjuvant sequence. We report on our institution's experience with patients who underwent short-course radiation therapy, consolidation chemotherapy, and surgery. Methods: We retrospectively reviewed surgical specimen outcomes, postoperative complications, and local/pelvic control in a large cohort of patients with LARC who underwent neoadjuvant therapy incorporating upfront short-course radiation therapy followed by consolidation chemotherapy. Results: In our cohort of 83 patients who proceeded to surgery, a complete/near-complete mesorectal specimen was achieved in 90 % of patients. This outcome was not associated with the time interval from completion of radiation to surgery. Postoperative complications were acceptably low. Local control at two years was 93.4 % for all patients- 97.6 % for those with low-risk disease and 90.4 % for high-risk disease. Conclusion: Upfront short-course radiation therapy and consolidation chemotherapy is an effective treatment course. Extended interval from completion of short-course radiation therapy did not impact surgical specimen quality. |
| first_indexed | 2024-03-08T11:26:20Z |
| format | Article |
| id | doaj.art-f56d4f51e4e94956af647a79a5ceec3e |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-04-24T14:28:30Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-f56d4f51e4e94956af647a79a5ceec3e2024-04-03T04:27:17ZengElsevierSurgery Open Science2589-84502024-03-01184249Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancerI-Chia Liu, MD0Susan Gearhart, MD MEd1Suqi Ke, MS2Chen Hu, PhD MS3Haniee Chung, MD4Jonathan Efron, MD5Alodia Gabre-Kidan, MD MPH6Peter Najjar, MD MBA7Chady Atallah, MD8Bashar Safar, MD9Eric S. Christenson, MD10Nilofer S. Azad, MD11Valerie Lee, MD12Atif Zaheer, MD13Jacqueline E. Birkness-Gartman, MD14Abhinav V. Reddy, MD15Amol K. Narang, MD16Jeffrey Meyer, MD MS17Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Colorectal Research Unit, Ravitch Division of Colorectal Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USADivision of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Colorectal Research Unit, Ravitch Division of Colorectal Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Colorectal Research Unit, Ravitch Division of Colorectal Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Colorectal Research Unit, Ravitch Division of Colorectal Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Colorectal Research Unit, Ravitch Division of Colorectal Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Surgery, Division of Colon and Rectal Surgery, NYU Langone Health, New York, NY, USADepartment of Surgery, Division of Colon and Rectal Surgery, NYU Langone Health, New York, NY, USADepartment of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USADepartment of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USADepartment of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USADepartment of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author at: Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, 401 North Broadway, Suite 1440, Baltimore, MD 21231, USA.Background: Total neoadjuvant therapy (TNT) is an accepted approach for the management of locally advanced rectal cancer (LARC) and is associated with a decreased risk of development of metastatic disease compared to standard neoadjuvant therapy. However, questions remain regarding surgical outcomes and local control in patients who proceed to surgery, particularly when radiation is given first in the neoadjuvant sequence. We report on our institution's experience with patients who underwent short-course radiation therapy, consolidation chemotherapy, and surgery. Methods: We retrospectively reviewed surgical specimen outcomes, postoperative complications, and local/pelvic control in a large cohort of patients with LARC who underwent neoadjuvant therapy incorporating upfront short-course radiation therapy followed by consolidation chemotherapy. Results: In our cohort of 83 patients who proceeded to surgery, a complete/near-complete mesorectal specimen was achieved in 90 % of patients. This outcome was not associated with the time interval from completion of radiation to surgery. Postoperative complications were acceptably low. Local control at two years was 93.4 % for all patients- 97.6 % for those with low-risk disease and 90.4 % for high-risk disease. Conclusion: Upfront short-course radiation therapy and consolidation chemotherapy is an effective treatment course. Extended interval from completion of short-course radiation therapy did not impact surgical specimen quality.http://www.sciencedirect.com/science/article/pii/S2589845024000174Rectal cancerRadiation therapyProctectomy |
| spellingShingle | I-Chia Liu, MD Susan Gearhart, MD MEd Suqi Ke, MS Chen Hu, PhD MS Haniee Chung, MD Jonathan Efron, MD Alodia Gabre-Kidan, MD MPH Peter Najjar, MD MBA Chady Atallah, MD Bashar Safar, MD Eric S. Christenson, MD Nilofer S. Azad, MD Valerie Lee, MD Atif Zaheer, MD Jacqueline E. Birkness-Gartman, MD Abhinav V. Reddy, MD Amol K. Narang, MD Jeffrey Meyer, MD MS Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer Surgery Open Science Rectal cancer Radiation therapy Proctectomy |
| title | Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer |
| title_full | Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer |
| title_fullStr | Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer |
| title_full_unstemmed | Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer |
| title_short | Surgical and local control outcomes after sequential short-course radiation therapy and chemotherapy for rectal cancer |
| title_sort | surgical and local control outcomes after sequential short course radiation therapy and chemotherapy for rectal cancer |
| topic | Rectal cancer Radiation therapy Proctectomy |
| url | http://www.sciencedirect.com/science/article/pii/S2589845024000174 |
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