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Surgery Today
Published in: Surgery Today 8/2019

01-08-2019 | Rectal Cancer | Original Article

Preoperative FOLFOX in resectable locally advanced rectal cancer can be a safe and promising strategy: the R-NAC-01 study

Authors: Nobuki Ichikawa, Shigenori Homma, Tohru Funakoshi, Masahiro Hattori, Masanori Sato, You Kamiizumi, Kazuyoshi Omori, Masaru Nomura, Ryoichi Yokota, Masahiko Koike, Hirofumi Kon, Keisa Takeda, Hiroyuki Ishizu, Kunihiro Hirose, Daisuke Kuraya, Takahisa Ishikawa, Ryohei Murata, Hiroaki Iijima, Futoshi Kawamata, Tadashi Yoshida, Yosuke Ohno, Nozomi Minagawa, Norihiko Takahashi, Akinobu Taketomi

Published in: Surgery Today | Issue 8/2019

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Abstract

Purpose

The aim of this study was to assess the safety of rectal surgery after 5-fluorouracil–leucovorin–oxaliplatin chemotherapy (FOLFOX6).

Methods

This was a prospective, multicenter study in 11 Japanese hospitals. We included patients with rectal cancer who received 4 courses of modified FOLFOX6 (mFOLFOX6) before rectal surgery and examined the postoperative complication rate, the clinicopathological response, and the rate of chemotherapy-related adverse events (UMIN 000012559).

Results

The study population included 36 men and 5 women. The average age of the patients was 60.8 years and the average body mass index was 23.1 kg/m2. After 4 courses of chemotherapy, grade 2 peripheral nerve disorder and other grade 3 adverse events were seen in 3 patients each (7.3%). Twenty-eight (73.7%) and 8 (21.1%) patients underwent low anterior resection and abdominoperineal resection, respectively. The pelvic nerves were preserved in 35 patients. Surgical morbidity (grade ≥ 3) occurred in 4 patients (10.5%). Anastomotic leakage occurred after surgery in 2 patients (7.1%). No patients achieved pathologically complete remission. However, downstaging of the clinical stage and N stage was seen in 17 (41.5%) and 22 (53.7%) patients, respectively.

Conclusions

Surgery after four courses of mFOLFOX6 chemotherapy can be a safe and promising strategy for patients with locally advanced rectal cancer.
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Metadata
Title
Preoperative FOLFOX in resectable locally advanced rectal cancer can be a safe and promising strategy: the R-NAC-01 study
Authors
Nobuki Ichikawa
Shigenori Homma
Tohru Funakoshi
Masahiro Hattori
Masanori Sato
You Kamiizumi
Kazuyoshi Omori
Masaru Nomura
Ryoichi Yokota
Masahiko Koike
Hirofumi Kon
Keisa Takeda
Hiroyuki Ishizu
Kunihiro Hirose
Daisuke Kuraya
Takahisa Ishikawa
Ryohei Murata
Hiroaki Iijima
Futoshi Kawamata
Tadashi Yoshida
Yosuke Ohno
Nozomi Minagawa
Norihiko Takahashi
Akinobu Taketomi
Publication date
01-08-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 8/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01788-8

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