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Role of adjuvant chemotherapy in locally advanced rectal cancer with ypT0-3N0 after preoperative chemoradiation therapy and surgery

Authors
 Chang Gon Kim  ;  Joong Bae Ahn  ;  Sang Joon Shin  ;  Seung Hoon Beom  ;  Su Jin Heo  ;  Hyung Soon Park  ;  Jee Hung Kim  ;  Eun Ah Choe  ;  Woong Sub Koom  ;  Hyuk Hur  ;  Byung Soh Min  ;  Nam Kyu Kim  ;  Hoguen Kim  ;  Chan Kim  ;  Inkyung Jung  ;  Minkyu Jung 
Citation
 BMC Cancer, Vol.17(1) : 615, 2017 
Journal Title
 BMC Cancer 
Issue Date
2017
Keywords
Adjuvant chemotherapy ; Disease-free survival ; Overall survival ; Rectal cancer
Abstract
BACKGROUND: We aimed to explore the clinical benefit of adjuvant chemotherapy (AC) with fluoropyrimidine in patients with ypT0-3N0 rectal cancer after preoperative chemoradiation therapy (CRT) followed by total mesorectal excision (TME). METHODS: Patients with ypT0-3N0 rectal cancer after preoperative CRT and TME were included using prospectively collected tumor registry cohort between January 2001 and December 2013. Patients were categorized into two groups according to the receipt of AC. Disease-free survival (DFS) and overall survival (OS) were compared between the adjuvant and observation groups. To control for potential confounding factors, we also calculated propensity scores and performed propensity score-matched analysis for DFS and OS. RESULTS: Of the 339 evaluated patients, 87 patients (25.7%) did not receive AC. There were no differences in DFS (hazard ratio [HR], 0.921; 95% confidence interval [CI], 0.562-1.507; P = 0.742) and OS (HR, 0.835; 95% CI, 0.423-1.648; P = 0.603) between the adjuvant and observation groups. After propensity score matching, DFS (HR, 1.129; 95% CI, 0.626-2.035; P = 0.688) and OS (HR, 1.200; 95% CI, 0.539-2.669; P = 0.655) did not differ between the adjuvant and observation groups. Advanced T stage and positive resection margin were independently associated with inferior DFS and OS on multivariate analysis. CONCLUSIONS: AC did not improve DFS and OS for patients with ypT0-3N0 rectal cancer after preoperative CRT followed by TME in this cohort study. The confirmative role of AC in locally advanced rectal cancer should be evaluated in prospective randomized trials with a larger sample size.
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DOI
10.1186/s12885-017-3624-7
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실)
Yonsei Authors
금웅섭(Koom, Woong Sub) ORCID logo https://orcid.org/0000-0002-9435-7750
김남규(Kim, Nam Kyu) ORCID logo https://orcid.org/0000-0003-0639-5632
김지형(Kim, Jee Hung) ORCID logo https://orcid.org/0000-0002-9044-8540
김호근(Kim, Ho Keun)
민병소(Min, Byung Soh)
박형순(Park, Hyung Soon)
신상준(Shin, Sang Joon) ORCID logo https://orcid.org/0000-0001-5350-7241
안중배(Ahn, Joong Bae) ORCID logo https://orcid.org/0000-0001-6787-1503
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
정인경(Jung, Inkyung)
최은아(Choe, Eun Ah)
허수진(Heo, Su Jin) ORCID logo https://orcid.org/0000-0002-0615-5869
허혁(Hur, Hyuk) ORCID logo https://orcid.org/0000-0002-9864-7229
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160717
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