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Locoregionally Advanced Rectal Cancer: Adjuvant Chemotherapy and Survival Outcomes

By: Cordi Craig
Posted: Tuesday, March 17, 2020

In the United States, the standard of care for patients with locoregionally advanced rectal cancer is chemoradiation therapy and surgery followed by adjuvant chemotherapy. A study published in JNCCN–Journal of the National Comprehensive Cancer Network by Daphna Y. Spiegel, MD, of Duke University, Durham, North Carolina, and colleagues supported the use of adjuvant chemotherapy. They found that overall and disease-specific survival rates were better among patients with rectal cancer who received adjuvant treatment than among those who did not. However, improvement in disease-specific survival seemed to benefit only those who received at least 4 months of adjuvant chemotherapy.

“Although adjuvant chemotherapy treatment decisions should be made based on patient and tumor characteristics, these data affirm current clinical practice and support ongoing studies examining a total neoadjuvant therapy approach,” the researchers concluded.

Using the Veterans Affairs Central Cancer Registry, the investigators identified 866 patients with stage II or III rectal cancer. Eligible patients had received neoadjuvant chemoradiation therapy and surgery with or without adjuvant chemotherapy. Overall, 417 patients received adjuvant chemotherapy, whereas 449 did not. The median follow-up was 109 months.

For those who received adjuvant chemotherapy, the 6-year disease-specific survival rate was 79.5%, versus 68.0% for those who did not receive adjuvant treatment. The median overall survival was 90.8 months. The 6-year overall survival was 64.3% for those who received adjuvant chemotherapy and 49.6% for those who did not. For patients who received at least 4 months of treatment, significant improvement was noted in disease-specific survival compared with those who were treated for less than 4 months (P = .023). No differences in survival rates between single-agent versus multiagent adjuvant chemotherapy were reported.

Disclosure: For full disclosures of the study authors, visit jnccn.org.



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