Impact of adjuvant chemotherapy on survival in ypT0-2 N0 rectal cancer.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-01-03 DOI:10.1007/s00384-024-04781-x

Mohamed Osama Alorabi, Abdelrahman Gouda, Mohammed Abdeen, Ahmed Said, Moamen Abdelaal, Reem Eid, Maha Yahia

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引用次数: 0

Abstract

Purpose: The role of adjuvant chemotherapy in rectal cancer patients downstaged to ypT0-2 N0 after neoadjuvant chemoradiotherapy (CRT), and surgery is still debated. This study investigates the impact of adjuvant chemotherapy on survival outcomes in this patient population.

Methods: This retrospective study analyzed hospital records of rectal cancer cases from Shefa Al Orman Cancer Hospital between January 2016 and December 2020, focusing on patients downstaged to ypT0-2 N0 after neoadjuvant CRT and surgery. Patients were divided into two groups based on whether they received adjuvant chemotherapy. Baseline characteristics, DFS, and OS were compared, and survival factors were analyzed using univariate and multivariate Cox regression.

Results: Eighty-five patients met the inclusion criteria; 55 received adjuvant chemotherapy, and 30 did not. The median age was 52, but those receiving adjuvant therapy were younger (47 vs. 60 years, P = 0.006). No significant differences were observed in sex, tumor location, or pathology between groups. Although adjuvant chemotherapy showed a trend toward better 3-year DFS (89.5% vs. 81.9%, P = 0.153) and OS (88.1% vs. 84.6%, P = 0.654), these differences were not statistically significant. Univariate and multivariate analyses confirmed no significant effect of adjuvant chemotherapy on DFS or OS, nor were any other variables significantly associated with survival.

Conclusion: Adjuvant chemotherapy did not significantly improve DFS or OS in rectal cancer patients downstaged to ypT0-2 N0 following neoadjuvant CRT and surgery. Further studies are needed to define the role of adjuvant therapy in this group.

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辅助化疗对ypt0 - 2n0直肠癌患者生存的影响。

目的：在新辅助放化疗（CRT）和手术后降期至ypT0-2 N0的直肠癌患者中，辅助化疗的作用仍有争议。本研究调查了辅助化疗对该患者群体生存结果的影响。方法：回顾性分析2016年1月至2020年12月Shefa Al Orman肿瘤医院直肠癌病例的住院记录，重点分析新辅助CRT和手术后降至ypT0-2 N0的患者。根据患者是否接受了辅助化疗，将患者分为两组。比较基线特征、DFS和OS，并使用单因素和多因素Cox回归分析生存因素。结果：85例患者符合纳入标准；55人接受了辅助化疗，30人没有。中位年龄为52岁，但接受辅助治疗的患者更年轻（47岁对60岁，P = 0.006）。各组在性别、肿瘤位置或病理上均无显著差异。虽然辅助化疗有改善3年DFS（89.5%比81.9%,P = 0.153）和OS（88.1%比84.6%,P = 0.654）的趋势，但差异无统计学意义。单因素和多因素分析证实，辅助化疗对DFS或OS没有显著影响，也没有任何其他变量与生存显著相关。结论：辅助化疗对新辅助CRT和手术后降至ypT0-2 N0期的直肠癌患者的DFS和OS没有显著改善。需要进一步的研究来确定辅助治疗在该组中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.