The impact of early adjuvant chemotherapy in rectal cancer
Although adjuvant chemotherapy (AC) has been established as a standard of treatment for advanced rectal cancer, there is no guideline regarding the timing of AC initiation. In this study, we aimed to evaluate the oncologic outcome of early AC initiation and clarify the ideal time to AC among rectal...
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| creator | Noh, Gyoung Tae Han, Jeonghee Cho, Min Soo Hur, Hyuk Lee, Kang Young Kim, Nam Kyu Min, Byung Soh |
| description | Although adjuvant chemotherapy (AC) has been established as a standard of treatment for advanced rectal cancer, there is no guideline regarding the timing of AC initiation. In this study, we aimed to evaluate the oncologic outcome of early AC initiation and clarify the ideal time to AC among rectal cancer patients receiving preoperative chemo-radiotherapy (preCRT).
The medical records of 719 patients who underwent curative resection followed by AC for rectal cancer were analyzed retrospectively. Data distributions were compared according to the calculated cut-off for AC initiation, survival results, and chemotherapy-induced toxicity. Additionally, patients were divided into two groups according to preCRT status and compared with respect to differences in the optimal time to AC.
Overall, a cut-off time point of 20 days after surgery for AC initiation was identified as the optimal interval; this yielded a significant difference in disease-free survival but no significant difference in AC toxicity. In the cut-off analysis of patients treated without preCRT, 19 days was identified as the optimal time to AC. However, for patients treated with preCRT, no significant value affected the survival outcome.
Earlier initiation of AC (within approximately 3 weeks) was associated with better oncological outcomes among patients with rectal cancer. Additionally, the optimal timing of AC was unclear among patients who received preCRT; this might be attributable to an undetermined role of AC after preCRT or the effects of complications such as anastomotic leakage. |
| doi_str_mv | 10.1371/journal.pone.0228060 |
| format | Article |
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The medical records of 719 patients who underwent curative resection followed by AC for rectal cancer were analyzed retrospectively. Data distributions were compared according to the calculated cut-off for AC initiation, survival results, and chemotherapy-induced toxicity. Additionally, patients were divided into two groups according to preCRT status and compared with respect to differences in the optimal time to AC.
Overall, a cut-off time point of 20 days after surgery for AC initiation was identified as the optimal interval; this yielded a significant difference in disease-free survival but no significant difference in AC toxicity. In the cut-off analysis of patients treated without preCRT, 19 days was identified as the optimal time to AC. However, for patients treated with preCRT, no significant value affected the survival outcome.
Earlier initiation of AC (within approximately 3 weeks) was associated with better oncological outcomes among patients with rectal cancer. Additionally, the optimal timing of AC was unclear among patients who received preCRT; this might be attributable to an undetermined role of AC after preCRT or the effects of complications such as anastomotic leakage.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0228060</identifier><identifier>PMID: 32004327</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adjuvant chemotherapy ; Aged ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Cancer ; Cancer patients ; Cancer research ; Cancer therapies ; Cancer treatment ; Care and treatment ; Chemotherapy ; Chemotherapy, Adjuvant - methods ; Colorectal cancer ; Comparative analysis ; Complications ; Disease-Free Survival ; Diseases ; Female ; Hospitals ; Humans ; Investigations ; Laparoscopy ; Male ; Medical prognosis ; Medical records ; Medical schools ; Medicine ; Medicine and Health Sciences ; Metastasis ; Middle Aged ; Patients ; Radiation therapy ; Radiotherapy ; Rectal Neoplasms - drug therapy ; Rectum ; Retrospective Studies ; Secondary Prevention - methods ; Surgery ; Survival ; Survival analysis ; Time ; Toxicity ; Treatment Outcome</subject><ispartof>PloS one, 2020-01, Vol.15 (1), p.e0228060</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Noh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Noh et al 2020 Noh et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-53d839f21e077b2a22c64e6a03cbbea90deee937c75f1706311a5742252bab183</citedby><cites>FETCH-LOGICAL-c692t-53d839f21e077b2a22c64e6a03cbbea90deee937c75f1706311a5742252bab183</cites><orcidid>0000-0001-8335-4776</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993968/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6993968/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32004327$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lee, Ju-Seog</contributor><creatorcontrib>Noh, Gyoung Tae</creatorcontrib><creatorcontrib>Han, Jeonghee</creatorcontrib><creatorcontrib>Cho, Min Soo</creatorcontrib><creatorcontrib>Hur, Hyuk</creatorcontrib><creatorcontrib>Lee, Kang Young</creatorcontrib><creatorcontrib>Kim, Nam Kyu</creatorcontrib><creatorcontrib>Min, Byung Soh</creatorcontrib><title>The impact of early adjuvant chemotherapy in rectal cancer</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Although adjuvant chemotherapy (AC) has been established as a standard of treatment for advanced rectal cancer, there is no guideline regarding the timing of AC initiation. In this study, we aimed to evaluate the oncologic outcome of early AC initiation and clarify the ideal time to AC among rectal cancer patients receiving preoperative chemo-radiotherapy (preCRT).
The medical records of 719 patients who underwent curative resection followed by AC for rectal cancer were analyzed retrospectively. Data distributions were compared according to the calculated cut-off for AC initiation, survival results, and chemotherapy-induced toxicity. Additionally, patients were divided into two groups according to preCRT status and compared with respect to differences in the optimal time to AC.
Overall, a cut-off time point of 20 days after surgery for AC initiation was identified as the optimal interval; this yielded a significant difference in disease-free survival but no significant difference in AC toxicity. In the cut-off analysis of patients treated without preCRT, 19 days was identified as the optimal time to AC. However, for patients treated with preCRT, no significant value affected the survival outcome.
Earlier initiation of AC (within approximately 3 weeks) was associated with better oncological outcomes among patients with rectal cancer. Additionally, the optimal timing of AC was unclear among patients who received preCRT; this might be attributable to an undetermined role of AC after preCRT or the effects of complications such as anastomotic leakage.</description><subject>Adjuvant chemotherapy</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Cancer treatment</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant - methods</subject><subject>Colorectal cancer</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Disease-Free Survival</subject><subject>Diseases</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Investigations</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Medical schools</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Rectal Neoplasms - drug therapy</subject><subject>Rectum</subject><subject>Retrospective Studies</subject><subject>Secondary Prevention - methods</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Time</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNkl2L1DAUhoso7of-A9GCsODFjPlok8YLYVn8GFhY0NXbcJqeTjO0zWySLs6_t-N0lykoSC4STp7znpM3J0leUbKkXNL3Gzf4Htrl1vW4JIwVRJAnySlVnC0EI_zp0fkkOQthQ0jOCyGeJyecEZJxJk-TD7cNprbbgompq1ME3-5SqDbDPfQxNQ12LjboYbtLbZ96NBHa1EBv0L9IntXQBnw57efJj8-fbq--Lq5vvqyuLq8XRigWFzmvCq5qRpFIWTJgzIgMBRBuyhJBkQoRFZdG5jWVRHBKIZcZYzkroaQFP0_eHHS3rQt6enbQjGeKyiwXaiRWB6JysNFbbzvwO-3A6j8B59cafLSmRa24GU0AVTBJsqKUqqhLgiajBS2pIPtqH6dqQ9lhZbCPHtqZ6Pymt41eu3stlOJK7AXeTgLe3Q0Y4j9anqg1jF3ZvnajmOlsMPpSUFbIPBPZSC3_Qo2rws6a8eNrO8ZnCe9mCSMT8VdcwxCCXn3_9v_szc85e3HENghtbIJrh2hdH-ZgdgCNdyF4rB-do0Tv5_bBDb2fWz3N7Zj2-tj1x6SHQeW_Aerx5eo</recordid><startdate>20200131</startdate><enddate>20200131</enddate><creator>Noh, Gyoung Tae</creator><creator>Han, Jeonghee</creator><creator>Cho, Min Soo</creator><creator>Hur, Hyuk</creator><creator>Lee, Kang Young</creator><creator>Kim, Nam Kyu</creator><creator>Min, Byung Soh</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-8335-4776</orcidid></search><sort><creationdate>20200131</creationdate><title>The impact of early adjuvant chemotherapy in rectal cancer</title><author>Noh, Gyoung Tae ; Han, Jeonghee ; Cho, Min Soo ; Hur, Hyuk ; Lee, Kang Young ; Kim, Nam Kyu ; Min, Byung Soh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-53d839f21e077b2a22c64e6a03cbbea90deee937c75f1706311a5742252bab183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adjuvant chemotherapy</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Cancer treatment</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant - methods</topic><topic>Colorectal cancer</topic><topic>Comparative analysis</topic><topic>Complications</topic><topic>Disease-Free Survival</topic><topic>Diseases</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Investigations</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical records</topic><topic>Medical schools</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Rectal Neoplasms - drug therapy</topic><topic>Rectum</topic><topic>Retrospective Studies</topic><topic>Secondary Prevention - methods</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Time</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Noh, Gyoung Tae</creatorcontrib><creatorcontrib>Han, Jeonghee</creatorcontrib><creatorcontrib>Cho, Min Soo</creatorcontrib><creatorcontrib>Hur, Hyuk</creatorcontrib><creatorcontrib>Lee, Kang Young</creatorcontrib><creatorcontrib>Kim, Nam Kyu</creatorcontrib><creatorcontrib>Min, Byung Soh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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In this study, we aimed to evaluate the oncologic outcome of early AC initiation and clarify the ideal time to AC among rectal cancer patients receiving preoperative chemo-radiotherapy (preCRT).
The medical records of 719 patients who underwent curative resection followed by AC for rectal cancer were analyzed retrospectively. Data distributions were compared according to the calculated cut-off for AC initiation, survival results, and chemotherapy-induced toxicity. Additionally, patients were divided into two groups according to preCRT status and compared with respect to differences in the optimal time to AC.
Overall, a cut-off time point of 20 days after surgery for AC initiation was identified as the optimal interval; this yielded a significant difference in disease-free survival but no significant difference in AC toxicity. In the cut-off analysis of patients treated without preCRT, 19 days was identified as the optimal time to AC. However, for patients treated with preCRT, no significant value affected the survival outcome.
Earlier initiation of AC (within approximately 3 weeks) was associated with better oncological outcomes among patients with rectal cancer. Additionally, the optimal timing of AC was unclear among patients who received preCRT; this might be attributable to an undetermined role of AC after preCRT or the effects of complications such as anastomotic leakage.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32004327</pmid><doi>10.1371/journal.pone.0228060</doi><tpages>e0228060</tpages><orcidid>https://orcid.org/0000-0001-8335-4776</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adjuvant chemotherapy Aged Antineoplastic Combined Chemotherapy Protocols - adverse effects Cancer Cancer patients Cancer research Cancer therapies Cancer treatment Care and treatment Chemotherapy Chemotherapy, Adjuvant - methods Colorectal cancer Comparative analysis Complications Disease-Free Survival Diseases Female Hospitals Humans Investigations Laparoscopy Male Medical prognosis Medical records Medical schools Medicine Medicine and Health Sciences Metastasis Middle Aged Patients Radiation therapy Radiotherapy Rectal Neoplasms - drug therapy Rectum Retrospective Studies Secondary Prevention - methods Surgery Survival Survival analysis Time Toxicity Treatment Outcome |
| title | The impact of early adjuvant chemotherapy in rectal cancer |
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