caa a22 4500 445338571 CHVBK 20180317142804.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1822-0 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1822-0 Long-Term Outcome of Patients with Complete Pathologic Response after Neoadjuvant Chemoradiation for cT3 Rectal Cancer: Implications for Local Excision Surgical Strategies [Elektronische Daten] [Claudio Belluco, Antonino De Paoli, Vincenzo Canzonieri, Roberto Sigon, Mara Fornasarig, Angela Buonadonna, Giovanni Boz, Roberto Innocente, Tiziana Perin, Marta Cossaro, Jerry Polesel, Francesco De Marchi] Background: Neoadjuvant chemoradiotherapy (CRT) followed by radical surgery including total mesorectal excision (TME) is standard treatment in patients with locally advanced rectal cancer. Emerging data indicate that patients with complete pathologic response (ypCR) after CRT have favorable outcome, suggesting the possibility of less invasive surgical treatment. We analyzed long-term outcome of cT3 rectal cancer treated by neoadjuvant CRT in relation to ypCR and type of surgery. Methods: The study population comprised 139 patients (93 men, 46 women; median age 62years) with cT3N0-1M0 mid and distal rectal adenocarcinoma treated by CRT and surgery (110 TME and 29 local excision) at our institution between 1996 and 2008. At pathology, ypCR was defined as no residual cancer cells in the primary tumor. Results: Tumors of 42 patients (30.2%) were classified as ypCR. After a median follow-up of 55.4months, comparing patients with ypCR to patients with no ypCR, 5-year disease-specific survival was 95.8% versus 78.0% (P=0.004), and 5-year disease-free survival was 90.1% vs. 64.0% (P=0.004). In patients with ypCR, no statistically significant outcome difference was observed between TME and local excision. In patients treated by local excision, comparing patients with ypCR to patients with no ypCR, 5-year disease-free survival was 100% vs. 65.5% (P=0.024), and 5-year local recurrence-free survival was 92.9% vs. 66.7% (P=0.047). Conclusions: With retrospective analysis limitations, our data confirm favorable long-term outcome of cT3 rectal cancer with ypCR after CRT and warrant clinical trials exploring local excision surgical strategies. The Author(s), 2011 Belluco Claudio Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut De Paoli Antonino Department of Radiotherapy, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Canzonieri Vincenzo Department of Pathology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Sigon Roberto Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Fornasarig Mara Department of Gastroenterology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Buonadonna Angela Department of Medical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Boz Giovanni Department of Radiotherapy, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Innocente Roberto Department of Radiotherapy, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Perin Tiziana Department of Pathology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Cossaro Marta Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Polesel Jerry Department of Epidemiology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut De Marchi Francesco Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3686-3693 1068-9265 18:13<3686 2011 18 10434 https://doi.org/10.1245/s10434-011-1822-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1822-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Belluco Claudio Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- De Paoli Antonino Department of Radiotherapy, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Canzonieri Vincenzo Department of Pathology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Sigon Roberto Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Fornasarig Mara Department of Gastroenterology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Buonadonna Angela Department of Medical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Boz Giovanni Department of Radiotherapy, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Innocente Roberto Department of Radiotherapy, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Perin Tiziana Department of Pathology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Cossaro Marta Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- Polesel Jerry Department of Epidemiology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 700 1- De Marchi Francesco Department of Surgical Oncology, CRO—IRCCS, National Cancer Institute, Aviano, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3686-3693 1068-9265 18:13<3686 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer