Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study
ABSTRACT Aim This study evaluated surgical complication rates, recurrence‐free survival, overall survival (OS), and stoma status of patients with rectal cancer after significant pathologic response following neoadjuvant treatment and curative resection. Pathologic complete response (pCR) and near‐pC...
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| Language: | English |
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Wiley
2024-11-01
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| Series: | Cancer Reports |
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| Online Access: | https://doi.org/10.1002/cnr2.70041 |
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| author | Fatemeh Shahabi Majid Ansari Khadijeh Najafi Ghobadi Abolfazl Ghahramani Amiresmaeil Parandeh Maryam Saberi‐Karimian Ala Orafaie Abbas Abdollahi |
| author_facet | Fatemeh Shahabi Majid Ansari Khadijeh Najafi Ghobadi Abolfazl Ghahramani Amiresmaeil Parandeh Maryam Saberi‐Karimian Ala Orafaie Abbas Abdollahi |
| author_sort | Fatemeh Shahabi |
| collection | DOAJ |
| description | ABSTRACT Aim This study evaluated surgical complication rates, recurrence‐free survival, overall survival (OS), and stoma status of patients with rectal cancer after significant pathologic response following neoadjuvant treatment and curative resection. Pathologic complete response (pCR) and near‐pCR patients constitute patients in our study. Methods Included was a retrospective cohort study of patients with rectal cancer who were diagnosed between July 2011 and September 2022 and who underwent neoadjuvant therapy and surgical resection. Results Of 696 patients with rectal cancer, 149 (21.4%) cases achieved significant pathologic response. During the 64 (70.5) months of follow‐up, recurrence occurred in 16.1% of patients and distant metastases account for the majority of them. Age (p = 0.014) and receiving adjuvant chemotherapy (p = 0.016) were significantly related to the occurrence of recurrence. The five‐year recurrence‐free survival (RFS) and OS rates were obtained at 83% and 87%, respectively. Although age and surgical technique were significant factors in univariate Cox regression analysis, none of the candidate variables were significant prognostic factors for RFS in the multiple models. The risk of surgical complications remained in these patients. The most frequent complication attributed to infection (20.8%). Despite the 24.8% presence of permanent stoma at primary surgery, more than 50% of our patients lived without stoma at the last follow‐up. Conclusion Our recurrence rate was about 16%, and it was related to age and adjuvant chemotherapy. These patients achieved over 80% rates of five‐year RFS and OS. No significant prognostic factors were found on RFS in the multivariable model. As a matter of course, the risk of surgical complications and permanent stoma has still remained in these patients. |
| format | Article |
| id | doaj-art-6fd6a84fe6b04db5b02c43d9d8a11b10 |
| institution | Kabale University |
| issn | 2573-8348 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Reports |
| spelling | doaj-art-6fd6a84fe6b04db5b02c43d9d8a11b102024-11-27T03:18:39ZengWileyCancer Reports2573-83482024-11-01711n/an/a10.1002/cnr2.70041Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort StudyFatemeh Shahabi0Majid Ansari1Khadijeh Najafi Ghobadi2Abolfazl Ghahramani3Amiresmaeil Parandeh4Maryam Saberi‐Karimian5Ala Orafaie6Abbas Abdollahi7Endoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranEndoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranDepartment of Biostatistics Ilam University of Medical Sciences Ilam IranEndoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranEndoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranEndoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranEndoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranEndoscopic and Minimally Invasive Surgery Research Center Mashhad University of Medical Sciences Mashhad IranABSTRACT Aim This study evaluated surgical complication rates, recurrence‐free survival, overall survival (OS), and stoma status of patients with rectal cancer after significant pathologic response following neoadjuvant treatment and curative resection. Pathologic complete response (pCR) and near‐pCR patients constitute patients in our study. Methods Included was a retrospective cohort study of patients with rectal cancer who were diagnosed between July 2011 and September 2022 and who underwent neoadjuvant therapy and surgical resection. Results Of 696 patients with rectal cancer, 149 (21.4%) cases achieved significant pathologic response. During the 64 (70.5) months of follow‐up, recurrence occurred in 16.1% of patients and distant metastases account for the majority of them. Age (p = 0.014) and receiving adjuvant chemotherapy (p = 0.016) were significantly related to the occurrence of recurrence. The five‐year recurrence‐free survival (RFS) and OS rates were obtained at 83% and 87%, respectively. Although age and surgical technique were significant factors in univariate Cox regression analysis, none of the candidate variables were significant prognostic factors for RFS in the multiple models. The risk of surgical complications remained in these patients. The most frequent complication attributed to infection (20.8%). Despite the 24.8% presence of permanent stoma at primary surgery, more than 50% of our patients lived without stoma at the last follow‐up. Conclusion Our recurrence rate was about 16%, and it was related to age and adjuvant chemotherapy. These patients achieved over 80% rates of five‐year RFS and OS. No significant prognostic factors were found on RFS in the multivariable model. As a matter of course, the risk of surgical complications and permanent stoma has still remained in these patients.https://doi.org/10.1002/cnr2.70041pathologic complete responserectal cancerrecurrencesignificant pathologic responsesurvival |
| spellingShingle | Fatemeh Shahabi Majid Ansari Khadijeh Najafi Ghobadi Abolfazl Ghahramani Amiresmaeil Parandeh Maryam Saberi‐Karimian Ala Orafaie Abbas Abdollahi Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study Cancer Reports pathologic complete response rectal cancer recurrence significant pathologic response survival |
| title | Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study |
| title_full | Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study |
| title_fullStr | Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study |
| title_full_unstemmed | Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study |
| title_short | Significant Pathologic Response Following Neoadjuvant Therapy and Curative Resection in Patients With Rectal Cancer: Surgical and Oncological Outcomes From a Retrospective Cohort Study |
| title_sort | significant pathologic response following neoadjuvant therapy and curative resection in patients with rectal cancer surgical and oncological outcomes from a retrospective cohort study |
| topic | pathologic complete response rectal cancer recurrence significant pathologic response survival |
| url | https://doi.org/10.1002/cnr2.70041 |
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