Status for clinically complete remission rectal cancer after concomitant chemo-radiotherapy in Taiwan

Geng-Ping Lin; Kuan-Der Lee; Jeng-Yi Wang; Jinn-Shiun Chen; Chun-Ju Chiang; Chien-Yuh Yeh

doi:10.1016/j.asjsur.2017.07.002

Status for clinically complete remission rectal cancer after concomitant chemo-radiotherapy in Taiwan

Asian J Surg. 2018 May;41(3):203-209. doi: 10.1016/j.asjsur.2017.07.002. Epub 2017 Sep 29.

Authors

Geng-Ping Lin¹, Kuan-Der Lee², Jeng-Yi Wang³, Jinn-Shiun Chen³, Chun-Ju Chiang⁴, Chien-Yuh Yeh⁵

Affiliations

¹ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
² Department of Hematology and Oncology, Taipei Medical University Hospital, Taipei, Taiwan.
³ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Clinical Medical Sciences, Chang-Gung University, Taoyuan, Taiwan.
⁴ Graduate Institution of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taipei, Taiwan.
⁵ Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Clinical Medical Sciences, Chang-Gung University, Taoyuan, Taiwan. Electronic address: chnyuh@gmail.com.

PMID: 28969958
DOI: 10.1016/j.asjsur.2017.07.002

Abstract

Treatment for Rectal cancer changed after the induction of concomitant chemo-radiotherapy, CCRT. Complete remission of the tumor leads to debate of the necessity of surgical intervention. We evaluate the treatment outcome to know if operation is beneficial to these patients. Patients received long course concomitant chemo-radiotherapy for advanced rectal cancer between 2004 and 2013 in Taiwan were enrolled. Total 2780 patients diagnosed advanced rectal cancer were enrolled. In these patients, 2578 received surgical intervention and 202 were in wait and see for complete remission tumor. Higher local recurrence rate was found with wait and see group (8.9% vs. 2.7%). Also, better overall survival, disease free survival and local recurrence free survival were seen with the surgical intervention group. Surgical intervention may be benefit for some misdiagnosed completed response to CCRT.

Keywords: Complete remission; Long course CCRT; Rectal cancer; Watch and wait.

MeSH terms

Adult
Aged
Aged, 80 and over
Chemoradiotherapy, Adjuvant*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoadjuvant Therapy*
Neoplasm Recurrence, Local / epidemiology
Neoplasm Recurrence, Local / etiology
Neoplasm Recurrence, Local / prevention & control
Rectal Neoplasms / mortality
Rectal Neoplasms / therapy*
Rectum / surgery
Retrospective Studies
Survival Analysis
Taiwan
Treatment Outcome