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International Journal of Colorectal Disease

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Open Access 01-04-2014 | Original Article

Selective use of adjuvant chemotherapy for rectal cancer patients with ypN0

Authors: Kai-yun You, Rong Huang, Pei-rong Ding, Bo Qiu, Guan-qun Zhou, Hui Chang, Wei-wei Xiao, Zhi-fan Zeng, Zhi-zhong Pan, Yuan-hong Gao

Published in: International Journal of Colorectal Disease | Issue 4/2014

Abstract

Background

The administration of adjuvant chemotherapy for rectal cancer patients with ypN0 is controversial. The purposes of this study were to evaluate the role of adjuvant chemotherapy in ypN0 patients and to optimize its use for these patients.

Methods

We performed a retrospective study of 160 rectal cancer patients who had the final pathology of ypN0 between March 2003 and November 2010. Overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared between patients who did and did not receive adjuvant chemotherapy. Multivariate analysis was performed to explore clinical factors significantly associated with DFS, LRFS, and DMFS.

Results

For ypT0–2N0 patients, the 5-year OS, DFS, LRFS, and DMFS were similar between patients who did and did not receive adjuvant chemotherapy (P > 0.05). For patients with ypT3–4N0, those who were given adjuvant chemotherapy exhibited a higher 5-year OS than those who were not (P = 0.026), with also an extended 5-year DFS (P = 0.050). Further analysis indicated that adjuvant chemotherapy could decrease the rates of distant metastases for ypT3–4N0 patients with no impact on local control. In multivariable analysis, both the final pathological stage and adjuvant chemotherapy were independent predictors of DMFS for the whole group. When stratified by pathological stage, adjuvant chemotherapy was still significantly associated with DMFS in the ypT3–4 stratum.

Conclusions

Adjuvant chemotherapy may not improve survival for ypT0–2N0 patients. However, it may be clinically meaningful for ypT3–4N0 patients by decreasing rates of distant metastases. Further randomized controlled clinical trials are needed to address this problem.

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Title: Selective use of adjuvant chemotherapy for rectal cancer patients with ypN0
Authors: Kai-yun You
Rong Huang
Pei-rong Ding
Bo Qiu
Guan-qun Zhou
Hui Chang
Wei-wei Xiao
Zhi-fan Zeng
Zhi-zhong Pan
Yuan-hong Gao
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 4/2014
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-014-1831-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Selective use of adjuvant chemotherapy for rectal cancer patients with ypN0

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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