Improved survival with adjuvant chemotherapy in locally advanced rectal cancer patients treated with preoperative chemoradiation regardless of pathologic response
The aim of this study is to examine the effect of postoperative chemotherapy on survival in patients with stage II or III rectal adenocarcinoma who undergo neoadjuvant chemoradiation (CRT) and surgical resection. A retrospective review of the National Cancer Database (NCDB) from 2006 to 2013 was per...
Gespeichert in:
| Veröffentlicht in: | Surgical oncology 2020-03, Vol.32, p.35-40 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 40 |
|---|---|
| container_issue | |
| container_start_page | 35 |
| container_title | Surgical oncology |
| container_volume | 32 |
| creator | Gahagan, John V. Whealon, Matthew D. Phelan, Michael J. Mills, Steven Jafari, Mehraneh D. Carmichael, Joseph C. Stamos, Michael J. Zell, Jason A. Pigazzi, Alessio |
| description | The aim of this study is to examine the effect of postoperative chemotherapy on survival in patients with stage II or III rectal adenocarcinoma who undergo neoadjuvant chemoradiation (CRT) and surgical resection.
A retrospective review of the National Cancer Database (NCDB) from 2006 to 2013 was performed. Cases were analyzed based on pathologic complete response (pCR) status and use of adjuvant therapy. The Kaplan-Meier method was used to estimate overall survival probabilities.
23,045 cases were identified, of which 5832 (25.31%) achieved pCR. In the pCR group, 1513 (25.9%) received adjuvant chemotherapy, and in the non-pCR group, 5966 (34.7%) received adjuvant therapy. In the pCR group, five-year survival probability was 87% (95% CI 84%–89%) with adjuvant therapy and 81% (95% CI 79%–82%) without adjuvant therapy. In the non-pCR group, five-year survival probability was 78% (95% CI 76%–79%) with adjuvant therapy and 70% (95% CI 69%–71%) without adjuvant therapy. In the non-pCR and node-negative subgroup (ypN-), five-year survival probability was 86% (95% CI 84%–88%) with adjuvant therapy and 76% (95% CI 74%–77%) without adjuvant therapy. In the non-pCR and node-positive subgroup (ypN+), five-year survival probability was 67% (95% CI 65%–70%) with adjuvant therapy and 60% (95% CI 58%–63%) without adjuvant therapy.
Adjuvant chemotherapy in stage II or III rectal adenocarcinoma is associated with increased five-year survival probability regardless of pCR status. We observed similar survival outcomes among non-pCR ypN- treated with adjuvant chemotherapy compared with patients achieving pCR treated with adjuvant chemotherapy.
•The use of adjuvant chemotherapy after neoadjuvant CRT national is overall quite low.•Achieving pCR is associated with a decreased use of adjuvant chemotherapy.•The use of adjuvant chemotherapy is associated with improved overall 5-year survival both in patients that achieve pCR and those that do not.•Similar overall survival outcomes were observed between pCR patients who received adjuvant chemotherapy and non-pCR node-negative (non-pCR ypN-) patients who received adjuvant chemotherapy. |
| doi_str_mv | 10.1016/j.suronc.2019.10.021 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2315104579</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0960740418303487</els_id><sourcerecordid>2315104579</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-d6e96e2ccc68f3c227917236c3442a1aa432394b0698ee1f5e4ada4fa5b495da3</originalsourceid><addsrcrecordid>eNp9kcuO1DAQRS0EYpqBP0AoEhs2afyK09kgoRGPkUZiA2ur2qlMO0rHwXaC-nf4UipkYMGClVWuc2_ZdRl7KfhecGHe9vs0xzC6veSioas9l-IR24lD3ZRKSf6Y7XhjeFlrrq_Ys5R6zrmppXjKrpSopdHisGM_b89TDAu2BbktfoGh-OHzqYC2nxcYc-FOeA75hBGmS-HHYggOhuFCALUd6SK6TCq3VrGYIHsccypyRMjU_u02RQwTWWS_4OYYofVUhpH09xDbAVMqQrfqT2EI995RI01hTPicPelgSPji4bxm3z5--Hrzubz78un25v1d6bQyuWwNNgalc84cOuWkrBv6pTJOaS1BAGglVaOP3DQHRNFVqKEF3UF11E3VgrpmbzZfWsj3GVO2Z58cDgOMGOZkpRKV4LqqG0Jf_4P2YY4jvY4oTYutaQhReqNcDClF7OwU_RnixQpu1wxtb7cM7ZrheksZkuzVg_l8PGP7V_QnNALebQDSNhaP0SZHS6cw_BqGbYP__4RfIUe0Ow</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2344187698</pqid></control><display><type>article</type><title>Improved survival with adjuvant chemotherapy in locally advanced rectal cancer patients treated with preoperative chemoradiation regardless of pathologic response</title><source>Access via ScienceDirect (Elsevier)</source><creator>Gahagan, John V. ; Whealon, Matthew D. ; Phelan, Michael J. ; Mills, Steven ; Jafari, Mehraneh D. ; Carmichael, Joseph C. ; Stamos, Michael J. ; Zell, Jason A. ; Pigazzi, Alessio</creator><creatorcontrib>Gahagan, John V. ; Whealon, Matthew D. ; Phelan, Michael J. ; Mills, Steven ; Jafari, Mehraneh D. ; Carmichael, Joseph C. ; Stamos, Michael J. ; Zell, Jason A. ; Pigazzi, Alessio</creatorcontrib><description>The aim of this study is to examine the effect of postoperative chemotherapy on survival in patients with stage II or III rectal adenocarcinoma who undergo neoadjuvant chemoradiation (CRT) and surgical resection.
A retrospective review of the National Cancer Database (NCDB) from 2006 to 2013 was performed. Cases were analyzed based on pathologic complete response (pCR) status and use of adjuvant therapy. The Kaplan-Meier method was used to estimate overall survival probabilities.
23,045 cases were identified, of which 5832 (25.31%) achieved pCR. In the pCR group, 1513 (25.9%) received adjuvant chemotherapy, and in the non-pCR group, 5966 (34.7%) received adjuvant therapy. In the pCR group, five-year survival probability was 87% (95% CI 84%–89%) with adjuvant therapy and 81% (95% CI 79%–82%) without adjuvant therapy. In the non-pCR group, five-year survival probability was 78% (95% CI 76%–79%) with adjuvant therapy and 70% (95% CI 69%–71%) without adjuvant therapy. In the non-pCR and node-negative subgroup (ypN-), five-year survival probability was 86% (95% CI 84%–88%) with adjuvant therapy and 76% (95% CI 74%–77%) without adjuvant therapy. In the non-pCR and node-positive subgroup (ypN+), five-year survival probability was 67% (95% CI 65%–70%) with adjuvant therapy and 60% (95% CI 58%–63%) without adjuvant therapy.
Adjuvant chemotherapy in stage II or III rectal adenocarcinoma is associated with increased five-year survival probability regardless of pCR status. We observed similar survival outcomes among non-pCR ypN- treated with adjuvant chemotherapy compared with patients achieving pCR treated with adjuvant chemotherapy.
•The use of adjuvant chemotherapy after neoadjuvant CRT national is overall quite low.•Achieving pCR is associated with a decreased use of adjuvant chemotherapy.•The use of adjuvant chemotherapy is associated with improved overall 5-year survival both in patients that achieve pCR and those that do not.•Similar overall survival outcomes were observed between pCR patients who received adjuvant chemotherapy and non-pCR node-negative (non-pCR ypN-) patients who received adjuvant chemotherapy.</description><identifier>ISSN: 0960-7404</identifier><identifier>EISSN: 1879-3320</identifier><identifier>DOI: 10.1016/j.suronc.2019.10.021</identifier><identifier>PMID: 31726418</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adenocarcinoma ; Adjuvant chemotherapy ; Cancer ; Cancer therapies ; Chemoradiotherapy ; Chemotherapy ; Colorectal cancer ; National cancer database ; Oncology ; Pathologic complete response ; Patients ; Probability ; Rectal cancer ; Rectum ; Statistical analysis ; Studies ; Subgroups ; Surgeons ; Survival ; Survival analysis</subject><ispartof>Surgical oncology, 2020-03, Vol.32, p.35-40</ispartof><rights>2019 Elsevier Ltd</rights><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><rights>2019. Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-d6e96e2ccc68f3c227917236c3442a1aa432394b0698ee1f5e4ada4fa5b495da3</citedby><cites>FETCH-LOGICAL-c436t-d6e96e2ccc68f3c227917236c3442a1aa432394b0698ee1f5e4ada4fa5b495da3</cites><orcidid>0000-0003-2738-7113 ; 0000-0003-2068-7391</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.suronc.2019.10.021$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31726418$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gahagan, John V.</creatorcontrib><creatorcontrib>Whealon, Matthew D.</creatorcontrib><creatorcontrib>Phelan, Michael J.</creatorcontrib><creatorcontrib>Mills, Steven</creatorcontrib><creatorcontrib>Jafari, Mehraneh D.</creatorcontrib><creatorcontrib>Carmichael, Joseph C.</creatorcontrib><creatorcontrib>Stamos, Michael J.</creatorcontrib><creatorcontrib>Zell, Jason A.</creatorcontrib><creatorcontrib>Pigazzi, Alessio</creatorcontrib><title>Improved survival with adjuvant chemotherapy in locally advanced rectal cancer patients treated with preoperative chemoradiation regardless of pathologic response</title><title>Surgical oncology</title><addtitle>Surg Oncol</addtitle><description>The aim of this study is to examine the effect of postoperative chemotherapy on survival in patients with stage II or III rectal adenocarcinoma who undergo neoadjuvant chemoradiation (CRT) and surgical resection.
A retrospective review of the National Cancer Database (NCDB) from 2006 to 2013 was performed. Cases were analyzed based on pathologic complete response (pCR) status and use of adjuvant therapy. The Kaplan-Meier method was used to estimate overall survival probabilities.
23,045 cases were identified, of which 5832 (25.31%) achieved pCR. In the pCR group, 1513 (25.9%) received adjuvant chemotherapy, and in the non-pCR group, 5966 (34.7%) received adjuvant therapy. In the pCR group, five-year survival probability was 87% (95% CI 84%–89%) with adjuvant therapy and 81% (95% CI 79%–82%) without adjuvant therapy. In the non-pCR group, five-year survival probability was 78% (95% CI 76%–79%) with adjuvant therapy and 70% (95% CI 69%–71%) without adjuvant therapy. In the non-pCR and node-negative subgroup (ypN-), five-year survival probability was 86% (95% CI 84%–88%) with adjuvant therapy and 76% (95% CI 74%–77%) without adjuvant therapy. In the non-pCR and node-positive subgroup (ypN+), five-year survival probability was 67% (95% CI 65%–70%) with adjuvant therapy and 60% (95% CI 58%–63%) without adjuvant therapy.
Adjuvant chemotherapy in stage II or III rectal adenocarcinoma is associated with increased five-year survival probability regardless of pCR status. We observed similar survival outcomes among non-pCR ypN- treated with adjuvant chemotherapy compared with patients achieving pCR treated with adjuvant chemotherapy.
•The use of adjuvant chemotherapy after neoadjuvant CRT national is overall quite low.•Achieving pCR is associated with a decreased use of adjuvant chemotherapy.•The use of adjuvant chemotherapy is associated with improved overall 5-year survival both in patients that achieve pCR and those that do not.•Similar overall survival outcomes were observed between pCR patients who received adjuvant chemotherapy and non-pCR node-negative (non-pCR ypN-) patients who received adjuvant chemotherapy.</description><subject>Adenocarcinoma</subject><subject>Adjuvant chemotherapy</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>National cancer database</subject><subject>Oncology</subject><subject>Pathologic complete response</subject><subject>Patients</subject><subject>Probability</subject><subject>Rectal cancer</subject><subject>Rectum</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Subgroups</subject><subject>Surgeons</subject><subject>Survival</subject><subject>Survival analysis</subject><issn>0960-7404</issn><issn>1879-3320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kcuO1DAQRS0EYpqBP0AoEhs2afyK09kgoRGPkUZiA2ur2qlMO0rHwXaC-nf4UipkYMGClVWuc2_ZdRl7KfhecGHe9vs0xzC6veSioas9l-IR24lD3ZRKSf6Y7XhjeFlrrq_Ys5R6zrmppXjKrpSopdHisGM_b89TDAu2BbktfoGh-OHzqYC2nxcYc-FOeA75hBGmS-HHYggOhuFCALUd6SK6TCq3VrGYIHsccypyRMjU_u02RQwTWWS_4OYYofVUhpH09xDbAVMqQrfqT2EI995RI01hTPicPelgSPji4bxm3z5--Hrzubz78un25v1d6bQyuWwNNgalc84cOuWkrBv6pTJOaS1BAGglVaOP3DQHRNFVqKEF3UF11E3VgrpmbzZfWsj3GVO2Z58cDgOMGOZkpRKV4LqqG0Jf_4P2YY4jvY4oTYutaQhReqNcDClF7OwU_RnixQpu1wxtb7cM7ZrheksZkuzVg_l8PGP7V_QnNALebQDSNhaP0SZHS6cw_BqGbYP__4RfIUe0Ow</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Gahagan, John V.</creator><creator>Whealon, Matthew D.</creator><creator>Phelan, Michael J.</creator><creator>Mills, Steven</creator><creator>Jafari, Mehraneh D.</creator><creator>Carmichael, Joseph C.</creator><creator>Stamos, Michael J.</creator><creator>Zell, Jason A.</creator><creator>Pigazzi, Alessio</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2738-7113</orcidid><orcidid>https://orcid.org/0000-0003-2068-7391</orcidid></search><sort><creationdate>202003</creationdate><title>Improved survival with adjuvant chemotherapy in locally advanced rectal cancer patients treated with preoperative chemoradiation regardless of pathologic response</title><author>Gahagan, John V. ; Whealon, Matthew D. ; Phelan, Michael J. ; Mills, Steven ; Jafari, Mehraneh D. ; Carmichael, Joseph C. ; Stamos, Michael J. ; Zell, Jason A. ; Pigazzi, Alessio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-d6e96e2ccc68f3c227917236c3442a1aa432394b0698ee1f5e4ada4fa5b495da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenocarcinoma</topic><topic>Adjuvant chemotherapy</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>National cancer database</topic><topic>Oncology</topic><topic>Pathologic complete response</topic><topic>Patients</topic><topic>Probability</topic><topic>Rectal cancer</topic><topic>Rectum</topic><topic>Statistical analysis</topic><topic>Studies</topic><topic>Subgroups</topic><topic>Surgeons</topic><topic>Survival</topic><topic>Survival analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gahagan, John V.</creatorcontrib><creatorcontrib>Whealon, Matthew D.</creatorcontrib><creatorcontrib>Phelan, Michael J.</creatorcontrib><creatorcontrib>Mills, Steven</creatorcontrib><creatorcontrib>Jafari, Mehraneh D.</creatorcontrib><creatorcontrib>Carmichael, Joseph C.</creatorcontrib><creatorcontrib>Stamos, Michael J.</creatorcontrib><creatorcontrib>Zell, Jason A.</creatorcontrib><creatorcontrib>Pigazzi, Alessio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gahagan, John V.</au><au>Whealon, Matthew D.</au><au>Phelan, Michael J.</au><au>Mills, Steven</au><au>Jafari, Mehraneh D.</au><au>Carmichael, Joseph C.</au><au>Stamos, Michael J.</au><au>Zell, Jason A.</au><au>Pigazzi, Alessio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved survival with adjuvant chemotherapy in locally advanced rectal cancer patients treated with preoperative chemoradiation regardless of pathologic response</atitle><jtitle>Surgical oncology</jtitle><addtitle>Surg Oncol</addtitle><date>2020-03</date><risdate>2020</risdate><volume>32</volume><spage>35</spage><epage>40</epage><pages>35-40</pages><issn>0960-7404</issn><eissn>1879-3320</eissn><abstract>The aim of this study is to examine the effect of postoperative chemotherapy on survival in patients with stage II or III rectal adenocarcinoma who undergo neoadjuvant chemoradiation (CRT) and surgical resection.
A retrospective review of the National Cancer Database (NCDB) from 2006 to 2013 was performed. Cases were analyzed based on pathologic complete response (pCR) status and use of adjuvant therapy. The Kaplan-Meier method was used to estimate overall survival probabilities.
23,045 cases were identified, of which 5832 (25.31%) achieved pCR. In the pCR group, 1513 (25.9%) received adjuvant chemotherapy, and in the non-pCR group, 5966 (34.7%) received adjuvant therapy. In the pCR group, five-year survival probability was 87% (95% CI 84%–89%) with adjuvant therapy and 81% (95% CI 79%–82%) without adjuvant therapy. In the non-pCR group, five-year survival probability was 78% (95% CI 76%–79%) with adjuvant therapy and 70% (95% CI 69%–71%) without adjuvant therapy. In the non-pCR and node-negative subgroup (ypN-), five-year survival probability was 86% (95% CI 84%–88%) with adjuvant therapy and 76% (95% CI 74%–77%) without adjuvant therapy. In the non-pCR and node-positive subgroup (ypN+), five-year survival probability was 67% (95% CI 65%–70%) with adjuvant therapy and 60% (95% CI 58%–63%) without adjuvant therapy.
Adjuvant chemotherapy in stage II or III rectal adenocarcinoma is associated with increased five-year survival probability regardless of pCR status. We observed similar survival outcomes among non-pCR ypN- treated with adjuvant chemotherapy compared with patients achieving pCR treated with adjuvant chemotherapy.
•The use of adjuvant chemotherapy after neoadjuvant CRT national is overall quite low.•Achieving pCR is associated with a decreased use of adjuvant chemotherapy.•The use of adjuvant chemotherapy is associated with improved overall 5-year survival both in patients that achieve pCR and those that do not.•Similar overall survival outcomes were observed between pCR patients who received adjuvant chemotherapy and non-pCR node-negative (non-pCR ypN-) patients who received adjuvant chemotherapy.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>31726418</pmid><doi>10.1016/j.suronc.2019.10.021</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-2738-7113</orcidid><orcidid>https://orcid.org/0000-0003-2068-7391</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0960-7404 |
| ispartof | Surgical oncology, 2020-03, Vol.32, p.35-40 |
| issn | 0960-7404 1879-3320 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2315104579 |
| source | Access via ScienceDirect (Elsevier) |
| subjects | Adenocarcinoma Adjuvant chemotherapy Cancer Cancer therapies Chemoradiotherapy Chemotherapy Colorectal cancer National cancer database Oncology Pathologic complete response Patients Probability Rectal cancer Rectum Statistical analysis Studies Subgroups Surgeons Survival Survival analysis |
| title | Improved survival with adjuvant chemotherapy in locally advanced rectal cancer patients treated with preoperative chemoradiation regardless of pathologic response |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T20%3A53%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Improved%20survival%20with%20adjuvant%20chemotherapy%20in%20locally%20advanced%20rectal%20cancer%20patients%20treated%20with%20preoperative%20chemoradiation%20regardless%20of%20pathologic%20response&rft.jtitle=Surgical%20oncology&rft.au=Gahagan,%20John%20V.&rft.date=2020-03&rft.volume=32&rft.spage=35&rft.epage=40&rft.pages=35-40&rft.issn=0960-7404&rft.eissn=1879-3320&rft_id=info:doi/10.1016/j.suronc.2019.10.021&rft_dat=%3Cproquest_cross%3E2315104579%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2344187698&rft_id=info:pmid/31726418&rft_els_id=S0960740418303487&rfr_iscdi=true |