| Strategic International Session (Symposium)3(JSGS・JSGE・JGES) |
| Sat. November 7th 9:00 - 11:00 Room 9: Portopia Hotel Main Building Kairaku 3 |
| Indications for neoadjuvant treatment based on risk factors before and after neoadjuvant chemotherapy alone in patients with locally advanced rectal cancer | |||
| Atsushi Ogura1, Keisuke Uehara1, Masato Nagino1 | |||
| 1Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine | |||
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| Introduction: The aim of this study was to clarify the clinical risk factors before and after neoadjuvant chemotherapy alone for decision making regarding additional treatment in patients with LARC. Materials and Methods: We examined a total of 96 patients with LARC treated by NAC alone between 2006 and 2018. Results: In the median follow-up duration after surgery of 60 months (3-120), the rates of 5-year overall survival (OS), relapse-free survival (RFS), and local recurrence (LR) were 83.6%, 78.4%, and 8.2%, respectively. In the multivariate analyses, patients with cT4 disease had a significantly higher risk of poor OS (HR; 6.10, 95% CI; 1.32-28.15, P = 0.021) than cT3 disease. After NAC, ycN+ was significantly associated with a higher risk of poor OS (HR; 6.70, 95% CI; 1.46-30.67, P = 0.014) and RFS (HR; 2.72, 95% CI; 1.08-6.81, P = 0.033) than ycN-. In addition, patients with CEA after NAC (post-CEA) ≥ 5 ng/ml had a significantly higher risk of poor RFS (HR; 2.50, 95% CI; 1.05-5.97, P = 0.039) and LR (HR; 5.63, 95% CI; 1.06-29.93, P = 0.043). Conclusion: NAC alone had an insufficient survival effect on patients with cT4 disease, ycN+, or an elevated post-CEA level. In contrast, NAC alone is a potential treatment for other patients with LARC. |
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Index Term 1: Neoadjuvant chemotherapy Index Term 2: rectal cancer |
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