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Effect of Neoadjuvant Chemoradiotherapy on Locally Advanced Rectal Mucinous Adenocarcinoma: A Propensity Score-Matched Study
- Source :
- Gastroenterology Research and Practice, Vol 2017 (2017)
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Aims. To compare the surgical and oncological outcomes of rectal mucinous adenocarcinomas treated with neoadjuvant chemoradiotherapy versus surgery alone. Methods. A total of 167 locally advanced rectal mucinous adenocarcinoma patients treated with neoadjuvant chemoradiotherapy and surgery alone between 2008 and 2014 were matched using propensity score; the surgical and oncological outcomes were compared. Results. Ninety-six patients were matched. Postoperative morbidity was similar between groups. Sphincter preservation rate was higher in patients receiving neoadjuvant chemoradiotherapy (79.2% versus 60.4%, P=0.045), especially for tumors ≥ 3 cm but ≤5 cm from the anal verge (75.0% versus 44.0%, P=0.036). With a median follow-up of 54.8 months, the 5-year overall survival rate (neoadjuvant chemoradiotherapy versus surgery alone: 79.6% versus 67.1%; P=0.599) and disease-free survival rate (75.6% versus 64.2%; P=0.888) were similar. The 5-year local recurrence rate was lower in patients receiving neoadjuvant chemoradiotherapy (7.7% versus 26.0%, P=0.036), while no difference was observed in distant metastasis. A poor response to chemoradiation was associated with higher local recurrence (P=0.037). Conclusions. Compared with surgery alone, neoadjuvant chemoradiotherapy was found to increase the sphincter preservation rate and reduce local recurrence, thus being beneficial for locally advanced rectal mucinous adenocarcinoma patients.
- Subjects :
- Diseases of the digestive system. Gastroenterology
RC799-869
Subjects
Details
- Language :
- English
- ISSN :
- 16876121 and 1687630X
- Volume :
- 2017
- Database :
- Directory of Open Access Journals
- Journal :
- Gastroenterology Research and Practice
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.1ce418189644b6182105582f0cf1d46
- Document Type :
- article
- Full Text :
- https://doi.org/10.1155/2017/5715219