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Even a partial pathological response is associated with lower relapse rates in patients with operable rectal cancer undergoing neoadjuvant chemotherapy
Author(s) -
Koizumi Michihiro,
Yamada Takeshi,
Shinji Seiichi,
Matsuda Akihisa,
Yokoyama Yasuyuki,
Takahashi Goro,
Iwai Takuma,
Takeda Kohki,
Hara Keisuke,
Yoshida Hiroshi
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26245
Subject(s) - medicine , folfox , oxaliplatin , colorectal cancer , chemotherapy , neoadjuvant therapy , pathological , regimen , oncology , fluorouracil , cancer , complete response , surgery , gastroenterology , breast cancer
Background Neoadjuvant chemotherapy to treat locally advanced rectal cancer is an effective therapeutic strategy for the prevention of local recurrence and distant organ metastasis after surgery. Objectives To assess the prognostic significance of histopathological tumor response in rectal cancer patients undergoing neoadjuvant chemotherapy. Methods This study included patients with operable rectal cancer who received neoadjuvant chemotherapy using the FOLFOX regimen (5‐fluorouracil, l ‐leucovorin, and oxaliplatin) in a hospital between February 2012 and November 2017. The main outcome measure was disease‐free survival with respect to histopathological response to neoadjuvant chemotherapy in resected specimens. Results The median follow‐up was 32 months. Of 48 patients treated with neoadjuvant FOLFOX, 24 (50%) were classified as responders, which included two patients with pathological complete response and 22 patients with partial response. The remaining 24 patients (50%) were classified as nonresponders. Responders had a significantly better 3‐year disease‐free survival than nonresponders (86% vs. 62%, p = .02). Conclusions Patients whose surgical specimens show a pathological complete response or partial response have good oncologic outcomes.