The Benefits of Adjuvant Chemotherapy for ypT3-4N0M0 Rectal Cancer Following Neoadjuvant Chemoradiation and Surgery.

IF 1.9 4区医学 Q3 ONCOLOGY

Clinical Medicine Insights-Oncology Pub Date : 2025-07-28 eCollection Date: 2025-01-01 DOI:10.1177/11795549251359151

Chih-Hsien Chang, Hung-Hsin Lin, Shih-Ching Chang, Jeng-Kai Jiang, Huann-Sheng Wang, Yuan-Tzu Lan

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Abstract

Background: Neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) is the current standard for locally advanced rectal cancer. This study aimed to evaluate the need for adjuvant chemotherapy and clinical outcomes in patients with ypT3-4N0M0 rectal cancer.

Methods: This is a retrospective cohort study. We reviewed the patients with locally advanced rectal cancer who had undergone radical resection after nCRT between 2010 and 2016. A total of 69 patients with ypT3-4N0M0 rectal cancer were included. The prognostic factors affecting disease-free and overall survival were analyzed.

Results: With clinical stage II-III and pathological stage II disease, the overall survival in the adjuvant chemotherapy group (n = 38) was better than that of the group without adjuvant chemotherapy (n = 31) (86.8%, vs 74.2%, P = 0.016). The disease-free survival was better in 2 groups, but the difference was not statistically significant (73.7%, vs 67.4%, P = 0.193).

Conclusions: In patients with clinical stage III rectal cancer downstaged to ypStage II after nCRT and TME, adjuvant chemotherapy may improve overall survival. nCRT combined with postoperative adjuvant chemotherapy remains an effective strategy for patients unsuitable for complete total neoadjuvant therapy protocols.

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新辅助放化疗和手术后辅助化疗对ypT3-4N0M0直肠癌的益处

背景：新辅助放化疗（nCRT）加全肠系膜切除（TME）是目前局部晚期直肠癌的标准治疗方案。本研究旨在评估ypT3-4N0M0直肠癌患者是否需要辅助化疗及临床结果。方法：回顾性队列研究。我们回顾了2010年至2016年间局部晚期直肠癌nCRT术后根治性切除的患者。共纳入69例ypT3-4N0M0直肠癌患者。分析影响无病生存和总生存的预后因素。结果：对于临床II- iii期和病理II期疾病，辅助化疗组（n = 38）的总生存率优于非辅助化疗组（n = 31）（86.8%, vs . 74.2%, P = 0.016）。两组患者无病生存率均较好，但差异无统计学意义（73.7% vs 67.4%, P = 0.193）。结论：在临床III期直肠癌患者在nCRT和TME后降至II期，辅助化疗可能提高总生存期。对于不适合完全新辅助治疗方案的患者，nCRT联合术后辅助化疗仍然是一种有效的策略。

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

Clinical Medicine Insights-Oncology Medicine-Oncology

CiteScore

2.40

自引率

4.50%

发文量

审稿时长

8 weeks

期刊介绍： Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological topics. Of particular but not exclusive importance are molecular biology, clinical interventions, controlled trials, therapeutics, pharmacology and drug delivery, and techniques of cancer surgery. The journal welcomes unsolicited article proposals.