Total mesorectal excision with or without preoperative chemoradiotherapy for resectable mid/low rectal cancer: a long-term analysis of a prospective, single-center, randomized trial

查看全文 作　　者：Fulong [1,2]Wang;Wenhua [1,2]Fan;Jianhong [1,2]Peng;Zhenhai [1,2]Lu;Zhizhong [1,2]Pan;Liren [1,2]Li;Yuanhong [1,3]Gao;Hui [4]Li;Gong [1,2]Chen;Xiaojun [1,2]Wu;Peirong [1,2]Ding;Zhifan [1,3]Zeng;Desen [1,2]Wan

机构地区：[1]Sun Yat-sen University Cancer Center,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060,Guangdong,P.R.China;[2]Department of Colorectal Surgery,Sun Yat-sen University Cancer Center,651 Dongfeng Road East,Guangzhou 510060,Guangdong,P.R.China;[3]Department of Radiation Oncology,Sun Yat-sen University Cancer Center,Guangzhou 510060,Guangdong,P.R.China;[4]Department of Gynecological Oncology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510060,Guangdong,P.R.China

出　　处：《Cancer Communications》索引2018年第38卷第1期,共10页

基　　金：funded by Sun Yat-sen University Clinical Research 5010 Program(Clinical Trial Number:ChiCTR-TRC-08000122). 摘　　要：Background:The preliminary results of our phase II randomized trial reported comparable functional sphincter pres-ervation rates and short-term survival outcomes between patients undergoing total mesorectal excision(TME)with or without preoperative concurrent chemoradiotherapy(CCRT).We now report the long-term results after a median follow-up of 71 months.Methods:Between March 23,2008 and August 2,2012,192 patients with T3-T4 or node-positive,resectable,mid/low rectal adenocarcinoma were randomly assigned to receive TME with or without preoperative CCRT.The following endpoints were assessed:cumulative rates of local recurrence and distant metastasis,disease-free survival(DFS),and overall survival(OS).Results:The data of 184 eligible patients were analyzed:94 patients in the TME group and 90 patients in the CCRT+TME group.In the whole cohort,the 5-year DFS and OS rates were 84.8%and 85.1%,respectively.The 5-year DFS rates were 85.2%in the CCRT+TME group and 84.3%in the TME group(P=0.969),and the 5-year OS rates were 83.5%in the CCRT+TME group and 86.5%in the TME group(P=0.719).The 5-year cumulative rates of local recur-rence were 6.3%and 5.0%(P=0.681),and the 5-year cumulative rates of distant metastasis were 15.0%and 15.7%(P=0.881)in the CCRT+TME and TME groups,respectively.No significant improvements in 5-year DFS and OS were observed with CCRT by subgroup analyses.Conclusions:Both treatment strategies yielded similar long-term outcomes.A selective policy towards preoperative CCRT is thus recommended for rectal cancer patients if high-quality TME surgery and enhanced chemotherapy can be performed. 关键词：Rectal cancer Total mesorectal excision CHEMORADIOTHERAPY Long-term outcomes Phase II randomized trial

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Total mesorectal excision with or without preoperative chemoradiotherapy for resectable mid/low rectal cancer: a long-term analysis of a prospective, single-center, randomized trial

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