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Impact of interval between neoadjuvant chemoradiotherapy and surgery in rectal cancer patients

World Journal of Gastroenterology 2020年第31期26卷 4624-4638页

作者： Shi-Wen Mei Zheng Liu Fang-Ze Wei Jia-Nan Chen Zhi-Jie Wang Hai-Yu Shen Juan Li Fu-Qiang Zhao Wei Pei Zheng Wang Xi-Shan Wang Qian Liu Department of Colorectal Surgery National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

BACKGROUND Epidemiologically,in China,locally advanced rectal cancer is a more common form of rectal *** neoadjuvant concurrent chemoradiotherapy can effectively reduce the size of locally invasive tumors and improve disease-free survival(DFS)and pathologic response after *** present,this modality has become the standard protocol for the treatment of locally advanced rectal cancer in many centers,but the optimal time for surgery after neoadjuvant therapy is still *** To investigate the impact of time interval between neoadjuvant therapy and surgery on DFS and pathologic response in patients with locally advanced rectal *** A total of 231 patients who were classified as having clinical stage II or III advanced rectal cancer and underwent neoadjuvant chemoradiation followed by surgery at the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from November 2014 to August 2017 were involved in this retrospective cohort *** patients were divided into two groups based on the different time intervals between neoadjuvant therapy and surgery:139(60.2%)patients were in group A(≤9 wk),and 92(39.2%)patients were in group B(>9 wk).DFS and pathologic response were analyzed as the primary *** secondary endpoints were postoperative complications and sphincter *** For the 231 patients included,surgery was performed at≤9 wk in 139(60.2%)patients and at>9 wk in 92(39.8%).The patients’clinical characteristics,surgical results,and tumor outcomes were analyzed through univariate analysis combined with multivariate regression *** overall pathologic complete response(pCR)rate was 27.2%(n=25)in the longer time interval group(>9 wk)and 10.8%(n=15)in the shorter time interval group(≤9 wk,P=0.001).The postoperative complications did not differ between the groups(group A,5%vs group B,5.4%;P=0.894).Surgical procedures for sphincter preservation were p

关键词： Interval time Advanced rectal cancer Disease-free survival Pathologic complete response Neoadjuvant therapy Surgery Complication sphincter preservation

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Evolving treatment strategies for colorectal cancer: A critical review of current therapeutic options

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World Journal of Gastroenterology 2014年第4期20卷 877-887页

作者： Daniel C Damin Anderson R Lazzaron Division of Coloproctology Department of Surgery Hospital de Clinicas de Porto Alegre Federal University of Rio Grande do Sul Postgraduate Program in Surgery Federal University of Rio Grande do Sul

Management of rectal cancer has markedly evolved over the last two *** technologies of staging have allowed a more precise definition of tumor *** in surgical concepts and techniques have resulted in higher rates of sphincter preservation and better functional outcome for patients with this ***,preoperative chemoradiotherapy followed by total mesorectal excision has become the standard of care for locally advanced tumors,many controversial matters in management of rectal cancer still need to be *** include the feasibility of a non-surgical approach after a favorable response to neoadjuvant therapy,the ideal margins of surgical resection for sphincter preservation and the adequacy of minimally invasive techniques of tumor *** this article,after an extensive search in PubMed and Embase databases,we critically review the current strategies and the most debatable matters in treatment of rectal cancer.

关键词： Rectal cancer Colorectal cancer Staging sphincter preservation Neoadjuvant chemo-radiotherapy Surgery

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