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2019 GI Symposium: Timing of Neoadjuvant Radiochemotherapy for Rectal Cancer

By: Sarah Campen, PharmD
Posted: Friday, February 1, 2019

In patients with cT3/T4 rectal cancer, performing surgery 11 weeks after neoadjuvant radiochemotherapy compared with 7 weeks appears to have no influence on prognosis or survival, according to the 3-year survival results of the GRECCAR6 trial. These findings were presented by Jeremie H. Lefevre, MD, PhD, of Hôpital Saint Antoine, Paris, and colleagues at the 2019 Gastrointestinal Cancers Symposium in San Francisco (Abstract 483).

The phase III trial enrolled 253 patients with cT3/T4 or node-positive disease of the mid or lower rectum. After radiochemotherapy, participants were randomly assigned to either a 7-week or 11-week waiting period prior to mesorectal excision. The rate of complete pathologic response in the 2 cohorts combined was 17% (n = 43), and overall survival at 3 years was 89%. The 3-year local and distant recurrences rates were 9.2% and 24.9%, respectively.

The researchers found no difference in overall survival (P = .9486) and disease-free survival (P = .8672) between the 2 cohorts. Distant (P = .8589) and local (P = .5780) recurrences were also not influenced by the longer waiting period. At 3 years, patients with a complete pathologic response had an “excellent” prognosis, with an overall survival of 94.5% versus 87.9% for the remaining patients. Lower rates of disease-free survival were noted in patients with low rectal tumors, R1 resection, and node-positive tumors.

Disclosure: The study authors’ disclosure information may be found at coi.asco.org.



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