An interval >7 weeks between neoadjuvant therapy and surgery improves pathologic complete response and disease-free survival in patients with locally advanced rectal cancer
An interval >7 weeks between neoadjuvant therapy and surgery improves pathologic complete response and disease-free survival in patients with locally advanced rectal cancer
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DOI：
10.1245/s10434-008-9892-3
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发表时间：
2008-10-01
影响因子：
3.7
通讯作者：
Rabau, Micha
中科院分区：
文献类型：
--
作者：
Tulchinsky, Hagit;Shmueli, Einat;Rabau, Micha
背景资料：我们评估了新辅助治疗和手术之间的时间间隔是否会影响手术和术后的发病率和死亡率，病理完全缓解（pCR）率，和疾病复发在局部进展期rectal cancer.Methods：132例局部进展期低位和中段直肠癌进行了新辅助放化疗，然后根治性切除术（2000年10月至2006年12月）。对新辅助治疗方案、新辅助治疗-手术间隔、最终病理学、手术类型、手术时间、术中输血、术后并发症、住院时间、疾病复发和死亡率等数据进行了回顾。结果：两组患者在人口统计学上基本相似，但A组患者手术时年龄较小。放化疗和手术之间的中位间隔为56天（范围13-173天）。37例患者（28%）达到pCR和接近pCR。53例患者（40%）出现并发症。无院内死亡。手术类型、手术时间、术中输血次数、术后并发症和住院时间不受间隔时间的影响。A、B组pCR率分别为17%、35%（P = 0.03）。手术间隔> 7周的患者无病生存率明显更高（P = 0.05）。结论：肿瘤-手术间隔> 7周与较高的pCR和接近pCR率、降低复发率和改善无病生存率相关。
Background: We assessed whether the time interval between neoadjuvant therapy and surgery affects the operative and postoperative morbidity and mortality, the pathologic complete response (pCR) rate, and disease recurrence in locally advanced rectal cancer.Methods: One-hundred and thirty-two patients with locally advanced low- and mid-rectal cancer underwent neoadjuvant chemoradiation followed by radical resection (October 2000 to December 2006). Data on the neoadjuvant regime, neoadjuvant-surgery interval, final pathology, type of operation, operative time, intraoperative blood transfusions, postoperative complications, length of hospital stay, disease recurrence, and mortality were reviewed. The patients were divided into two groups according to the neoadjuvant-surgery interval: > 7 weeks (group A, n = 48), and > 7 weeks (group B, n = 84).Results: The groups were demographically comparable except for the group A patients being younger at operation. The median interval between chemoradiation and surgery was 56 days (range 13-173 days). Thirty-seven patients (28%) had a pCR and near pCR. Fifty three patients (40%) had complications. There was no in-hospital mortality. Surgery type, operative time, number of intraoperative blood transfusions, postoperative complications, and length of hospitalization were not influenced by the interval length. The pCR and near pCR rates were higher with longer interval: 17% in group A, 35% in group B (P = 0.03). Patients operated at an interval > 7 weeks had significantly better disease-free survival (P = 0.05).Conclusions: A neoadjuvant-surgery interval > 7 weeks was associated with higher rates of pCR and near pCR, decreased recurrence and improved disease-free survival.