Role of neoadjuvant treatment in cT3N0M0 rectal cancer

Lara Maria Pasetto, Maria Luisa Friso, Salvatore Pucciarelli, Umberto Basso, Massimo Rugge, Giulietta Sinigaglia, Elena Rossi, Alessia Compostella, Paola Toppan, Marco Agostini, Silvio Monfardini

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Abstract

Background: The aim of the study was to evaluate the pathological response (pTNM), local relapse and overall survival (OS) in clinical T3N0M0 (cT3N0M0) rectal cancer after a neoadjuvant chemoradiotherapy (CHT-RT) with 5-fluorouracil (5-FU) continuous infusion (c.i.) (± oxaliplatin) or bolus or capecitabine (an oral fluorpyrimidine). A secondary endpoint was to identify the local relapse rate and OS in those patients also receiving an adjuvant chemotherapy. Patients and Methods: From January 2000 to January 2006, 48 consecutive cT3N0M0 rectal cancer cases neoadjuvantly treated were retrospectively examined. Variables considered were age, gender, modality of 5-FU administration and tumour site. Results: Median age was 64 years (range, 22-84 years) and the male female ratio was 28:20. All the patients received the full course of CHT-RT. Twenty-eight patients received c.i. 5-FU neoadjuvant chemotherapy, 17 received bolus 5-FU administration and 3 patients received capecitabine-based therapy. The mean number of chemotherapy weeks was 4.9 (range, 2-6). A total of 85.4% of patients were operated on without relevant postoperative complications but another 4 are awaiting surgery. Twenty-one patients had a lower (≤5 cm from the anal verge) and 27 had a middle rectal lesion (from 6 to 10 cm). In those patients with the lower site of lesion, a sphincter-saving (SS) procedure was achieved in 88.9%. Downstaging was reported in 66.7%. Ninety percent of cases are still free from progression after a median follow-up of 22.1 months; 7.5% are dead. Conclusion: The down-staging, the good level of SS and the disease-free survival (DFS) obtained here suggests that a neoadjuvant therapy may also be useful for stage II rectal cancer at diagnosis. The use of a postoperative chemotherapy should probably be outlined better.

Original languageEnglish
Pages (from-to)4129-4135
Number of pages7
JournalAnticancer Research
Volume28
Issue number6 B
Publication statusPublished - Nov 2008

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Keywords

  • cT3N0M0
  • Neoadjuvant chemotherapy
  • Rectal cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pasetto, L. M., Friso, M. L., Pucciarelli, S., Basso, U., Rugge, M., Sinigaglia, G., Rossi, E., Compostella, A., Toppan, P., Agostini, M., & Monfardini, S. (2008). Role of neoadjuvant treatment in cT3N0M0 rectal cancer. Anticancer Research, 28(6 B), 4129-4135.