TY - JOUR
T1 - Adjuvant treatment for locally advanced rectal cancer patients after preoperative chemoradiotherapy
T2 - When, and for whom?
AU - De Stefano, Alfonso
AU - Moretto, Roberto
AU - Bucci, Luigi
AU - Pepe, Stefano
AU - Romano, Francesco Jacopo
AU - Cella, Alessandra Chiara
AU - Attademo, Laura
AU - Rosanova, Mario
AU - De Falco, Stefano
AU - Fiore, Giovanni
AU - Raimondo, Lucia
AU - De Placido, Sabino
AU - Carlomagno, Chiara
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Background The standard treatment for patients with locally advanced rectal cancer (clinical tumor, node, metastases [TNM] stage II or III) is radiotherapy before surgery (with or without concomitant fluoropyrimidine-based chemotherapy) followed by surgery. The role of adjuvant chemotherapy in this setting of patients is controversial in terms of the overall benefit on survival, the subgroup of patients who might not need it, and the best regimen (combination regimens vs. fluoropyrimidine alone).Patients and Methods Based on the retrospective analysis of the clinical outcome of all patients with locally advanced rectal adenocarcinoma treated at our institute during the past 9 years, we comment on prognostic factors for local and distant metastases of patients who received neoadjuvant treatment followed by surgery, and the scientific evidence that can help to decide the adjuvant chemotherapy.Results We conclude that pathological TNM stage after neoadjuvant chemoradiation (ypTNM) stage after surgery significantly affects disease-free and overall survival. In particular, patients with pathologically positive lymph nodes (ypN+) after surgery have a high probability of developing distant metastases.Conclusion ypN+ patients are candidate for intensified adjuvant chemotherapy.
AB - Background The standard treatment for patients with locally advanced rectal cancer (clinical tumor, node, metastases [TNM] stage II or III) is radiotherapy before surgery (with or without concomitant fluoropyrimidine-based chemotherapy) followed by surgery. The role of adjuvant chemotherapy in this setting of patients is controversial in terms of the overall benefit on survival, the subgroup of patients who might not need it, and the best regimen (combination regimens vs. fluoropyrimidine alone).Patients and Methods Based on the retrospective analysis of the clinical outcome of all patients with locally advanced rectal adenocarcinoma treated at our institute during the past 9 years, we comment on prognostic factors for local and distant metastases of patients who received neoadjuvant treatment followed by surgery, and the scientific evidence that can help to decide the adjuvant chemotherapy.Results We conclude that pathological TNM stage after neoadjuvant chemoradiation (ypTNM) stage after surgery significantly affects disease-free and overall survival. In particular, patients with pathologically positive lymph nodes (ypN+) after surgery have a high probability of developing distant metastases.Conclusion ypN+ patients are candidate for intensified adjuvant chemotherapy.
KW - Adjuvant chemotherapy
KW - Lymph nodes
KW - Preoperative chemoradiotherapy
KW - Prognostic factors
KW - Rectal cancer
UR - http://www.scopus.com/inward/record.url?scp=84908170073&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908170073&partnerID=8YFLogxK
U2 - 10.1016/j.clcc.2014.05.004
DO - 10.1016/j.clcc.2014.05.004
M3 - Article
C2 - 25080847
AN - SCOPUS:84908170073
VL - 13
SP - 185
EP - 191
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
SN - 1533-0028
IS - 3
ER -