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Poster display - Cocktail

348 - Maintenance therapy with monthly tegafur-uracil for improving disease-free survival of patients with ypStage III rectal cancer

Date

24 Nov 2018

Session

Poster display - Cocktail

Presenters

Yi Hung Kuo

Citation

Annals of Oncology (2018) 29 (suppl_9): ix28-ix45. 10.1093/annonc/mdy431

Authors

Y.H. Kuo

Author affiliations

  • Division Of Colon And Rectal Surgery, Department Of Surgery, Chiayi ChangGung Medical Foundation, 613 - Chiayi/TW
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Resources

Abstract 348

Background

Preoperative radiotherapy (RT) alone or with chemotherapy (CRT) has become the current standard for locally advanced rectal cancers. In the era of total mesorectal excision (TME), neoadjuvant RT/CRT has not shown a benefit on OS. Adjuvant chemotherapy or further maintenance therapy may have a promising role in influencing the survival of patients with ypStage III rectal cancer. Although adjuvant chemotherapy for ypStage III rectal cancer after preoperative RT or CRT and curative surgery is recommended in the National Comprehensive Cancer Network (NCCN) guideline, maintenance treatment with monthly tegafur-uracil following adjuvant chemotherapy for improved survival of colorectal cancer is uncommon and lacks evidence.

Methods

The retrospective enrollment analyzed 259 patients with locally advanced rectal cancer, defined as T3 or T4 or node-positive according to the TNM system. All patients received preoperative RT at Chang Gung Medical Foundation, Chiayi Branch, from January 2006 through December 2015. Total 102 patients with ypStage III rectal cancer were enrolled from among 259 patients for further study.

Results

The median follow-up duration in this study was 62.6 months. The enrolled patients included 59 men and 43 women. The mean ages in the maintenance and observation groups were 62.2 and 65.7 years, respectively. The maintenance group had significantly better three-year DFS than that of the observation group (84.6% vs. 64.5%, p = 0.023). However, the five-year cancer-specific survival did not differ significantly between the maintenance and observation groups (81.2% vs. 75.7%, p = 0.385). Multivariate analysis with forward stepwise regression confirmed that lower rectal cancer (< 6 cm from the anal verge), metastatic lymph nodes ratio (≥ 0.3), and tegafur-uracil maintenance (≥ 6 cycles) were independent prognostic factors for three-year DFS. Patients with a higher location of rectal cancer wound (≥ 6 cm) had a significant survival benefit from tegafur-uracil maintenance (p = 0.023).

Conclusions

Adding monthly tegafur-uracil (≥ 6 cycles) following fluorouracil-based adjuvant chemotherapy potentially could improve the three-year DFS in patients with ypStage III rectal cancer.

Editorial acknowledgement

Cancer Registry of the Chang Gung Medical Foundation of Chiayi.

Clinical trial identification

N/A

Legal entity responsible for the study

Institutional Review Board of Chang Gung Memorial Hospital (IRB No.: 201601450B0).

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

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