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Adjuvant Chemotherapy after Neoadjuvant Chemotherapy and Long-term Outcomes of CAPOX Plus Bevacizumab Followed by TME for High-risk Localized Rectal Cancer.

Authors
  • Nishimura, Junichi1
  • Hasegawa, Junichi2
  • Noura, Shingo2
  • Ikeda, Kimimasa3
  • Yasui, Masayoshi1
  • Komori, Takamichi4
  • Tsujie, Masaki5
  • Yasumasa, Keigo6
  • Shingai, Tatsushi7
  • Uemura, Mamoru8
  • Hata, Taishi8
  • Matsuda, Chu8
  • Mizushima, Tsunekazu8
  • Ikeda, Masataka9
  • Doki, Yuichiro8
  • Mori, Masaki10
  • 1 Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan. , (Japan)
  • 2 Department of Surgery, Osaka Rosai Hospital, Sakai, Japan. , (Japan)
  • 3 Department of Surgery, Minoh City Hospital, Minoh, Japan. , (Japan)
  • 4 Department of Surgery, Osaka General Medical Center, Osaka, Japan. , (Japan)
  • 5 Department of Surgery, Sakai City Medical Center, Sakai, Japan. , (Japan)
  • 6 Department of Surgery, JCHO Osaka Hospital, Osaka, Japan. , (Japan)
  • 7 Department of Surgery, Saiseikai Senri Hospital, Suita, Japan. , (Japan)
  • 8 Department of Gastroenterological Surgery, Osaka University, Suita, Japan. , (Japan)
  • 9 Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan. , (Japan)
  • 10 Department of Surgery and Science, Kyushu University, Fukuoka, Japan. , (Japan)
Type
Published Article
Journal
Journal of the anus, rectum and colon
Publication Date
Jan 01, 2020
Volume
4
Issue
3
Pages
108–113
Identifiers
DOI: 10.23922/jarc.2019-042
PMID: 32743112
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We previously reported the feasibility of neoadjuvant capecitabine and oxaliplatin plus bevacizumab as a treatment for locally advanced rectal cancer (UMIN000003219). The aim of this study is to investigate the prognostic relevance of neoadjuvant chemotherapy followed by total mesorectal resection (TME). Twenty-five patients of our prior multicenter prospective study of neoadjuvant chemotherapy followed by TME enrolled to this study. We analyzed the adjuvant chemotherapy regimen, and the duration between surgery and initial chemotherapy treatment. Five-year progression-free survival and overall survival were estimated using the Kaplan-Meier method. Among survivors, the median follow-up time was 66 months. Recurrence occurred in six patients, all of whom had suboptimal tumor regression after neoadjuvant chemotherapy. Five patients died from other causes. The rate of local recurrence and distant metastasis was 17.4% and 8.7%, respectively. Five-year progression-free survival was 70.0%, and 5 year overall survival was 84.0%. We report the long-term survival of patients who received neoadjuvant chemotherapy without radiation followed by TME, revealing a generally favorable prognosis. Copyright © 2020 by The Japan Society of Coloproctology.

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