caa a22 4500 445334851 CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1324-5 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1324-5 Outcome Standards for an Organ Preservation Strategy in Stage II and III Rectal Adenocarcinoma after Neoadjuvant Chemoradiation [Elektronische Daten] [Albert Wolthuis, Freddy Penninckx, Karin Haustermans, Nadine Ectors, Eric Van Cutsem, André D'Hoore] Background: Neoadjuvant chemoradiotherapy is the standard of care for patients with locally advanced mid and distal rectal cancer. Tumor regression is variable, and this study was designed to evaluate the pathological response and impact on long-term disease control in responders and nonresponders. Methods: A total of 303 consecutive patients with cStage II and III mid and distal rectal adenocarcinoma were identified. The mean age was 64years and 63% were men. Patients received neoadjuvant chemoradiotherapy (45Gy) with a continuous infusion of 5-fluorouracil. Total mesorectal excision (TME) was performed after an interval of 6-8weeks. Tumors were stratified as responders (ypT0 or ypT1) and nonresponders (≥ypT3). All ypT2 were separately categorized. Results: Tumors of 84 patients were classified as responders (27.5%) versus nonresponders in 144 patients (47.5%). Pathological tumor stage was ypT2 in 75 patients (25%). After a median follow-up of 55months, the 5-year cancer-specific survival rate was 98% and the disease-free survival rate was 91% in responders versus 82% (P<0.0025) and 60% (P<0.0001), respectively, for the nonresponders. Conclusions: After neoadjuvant chemoradiotherapy and TME surgery for locally advanced rectal cancer and complete or near-complete pathological tumor response oncological outcome is very good. These results set the standards for a rectum-sparing strategy. Society of Surgical Oncology, 2010 Wolthuis Albert Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium aut Penninckx Freddy Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium aut Haustermans Karin Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven, Belgium aut Ectors Nadine Department of Pathology, University Hospital Gasthuisberg, Leuven, Belgium aut Van Cutsem Eric Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium aut D'Hoore André Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 684-690 1068-9265 18:3<684 2011 18 10434 https://doi.org/10.1245/s10434-010-1324-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1324-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wolthuis Albert Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium aut NATIONALLICENCE 700 1- Penninckx Freddy Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium aut NATIONALLICENCE 700 1- Haustermans Karin Department of Radiation Oncology, University Hospital Gasthuisberg, Leuven, Belgium aut NATIONALLICENCE 700 1- Ectors Nadine Department of Pathology, University Hospital Gasthuisberg, Leuven, Belgium aut NATIONALLICENCE 700 1- Van Cutsem Eric Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium aut NATIONALLICENCE 700 1- D'Hoore André Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 684-690 1068-9265 18:3<684 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer