A Matched-Pair Study Comparing Surgery Plus Neoadjuvant Radio-Chemotherapy and Surgery Alone for High Rectal Cancers

TY - JOUR

T1 - A Matched-Pair Study Comparing Surgery Plus Neoadjuvant Radio-Chemotherapy and Surgery Alone for High Rectal Cancers

AU - Rades, Dirk

AU - Vogelsang, Rasmus Peuliche

AU - Treder, Maxi

AU - Janssen, Stefan

AU - Schild, Steven E

AU - Holländer, Niels Henrik

AU - Gögenur, Ismail

N1 - Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

PY - 2018/12

Y1 - 2018/12

N2 - Background/Aim: The value of neoadjuvant radiochemotherapy for high rectal cancers is controversial. This study compared surgery plus neoadjuvant radiochemotherapy to surgery alone. Patients and Methods: Fifty-two patients with stage II/III high rectal cancers treated with surgery plus neoadjuvant radiochemotherapy were matched (1:4) to 208 patients treated with surgery alone. Matching criteria included age (≤65 vs. >65 years), gender and UICC-stage (II vs. III). These criteria were identical in all five patients used for each 1:4 matching. Both groups were compared for overall survival (OS). Results: On univariate analyses, age ≤65 years (p<0.001) was significantly associated with improved OS. A trend towards improved OS was found for neoadjuvant radiochemotherapy (p=0.078) and UICC-stage II (p=0.060). On multivariate analysis, age (p<0.001) remained significant, and neoadjuvant radiochemotherapy showed a trend towards better OS (p=0.073). Conclusion: Given the limitations of this study, the results showed that neoadjuvant radiochemotherapy may improve OS in patients with stage II/III high rectal cancers. However, these results need to be verified in a prospective randomized trial.

AB - Background/Aim: The value of neoadjuvant radiochemotherapy for high rectal cancers is controversial. This study compared surgery plus neoadjuvant radiochemotherapy to surgery alone. Patients and Methods: Fifty-two patients with stage II/III high rectal cancers treated with surgery plus neoadjuvant radiochemotherapy were matched (1:4) to 208 patients treated with surgery alone. Matching criteria included age (≤65 vs. >65 years), gender and UICC-stage (II vs. III). These criteria were identical in all five patients used for each 1:4 matching. Both groups were compared for overall survival (OS). Results: On univariate analyses, age ≤65 years (p<0.001) was significantly associated with improved OS. A trend towards improved OS was found for neoadjuvant radiochemotherapy (p=0.078) and UICC-stage II (p=0.060). On multivariate analysis, age (p<0.001) remained significant, and neoadjuvant radiochemotherapy showed a trend towards better OS (p=0.073). Conclusion: Given the limitations of this study, the results showed that neoadjuvant radiochemotherapy may improve OS in patients with stage II/III high rectal cancers. However, these results need to be verified in a prospective randomized trial.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Case-Control Studies

KW - Chemoradiotherapy

KW - Combined Modality Therapy

KW - Digestive System Surgical Procedures

KW - Female

KW - Humans

KW - Male

KW - Matched-Pair Analysis

KW - Middle Aged

KW - Neoadjuvant Therapy

KW - Rectal Neoplasms/pathology

KW - Retrospective Studies

U2 - 10.21873/anticanres.13063

DO - 10.21873/anticanres.13063

M3 - Journal article

C2 - 30504404

SN - 0250-7005

VL - 38

SP - 6877

EP - 6880

JO - Anticancer Research

JF - Anticancer Research

IS - 12

ER -