Abstract 97P
Background
Adjuvant chemotherapy has been recommended for patients who have locally advanced rectal cancer. However, the role of adjuvant chemotherapy in patients with positive surgical margin has not been clarified. We investigated the benefit of adjuvant chemotherapy according to the surgical margin in locally advanced rectal cancer.
Methods
A total of 1801 rectal cancer patients staging cT3-4N0-2M0 were included. The patients were eligible when tumors were pathologically confirmed adenocarcinoma, located within 10cm from anal verge, and staged cT3-4N0-2M0. Before surgery, all patients received radiation therapy at a dose of 50.4 Gy in 28 fractions with concurrent 5-fluorouracil or capecitabine. Curative surgery including TME was performed 4 to 8 weeks after radiotherapy. Adjuvant chemotherapy was performed after 4-6 weeks after surgery.
Results
Adjuvant chemotherapy was given to 1531 patients (85.0%). Patients with positive circumferential resection margin or distal resection margin were 205 (11.4%). With patients with positive surgical margin (n = 205), the 5-year recurrence-free survival (RFS) showed a significant difference between adjuvant chemotherapy group and no adjuvant chemotherapy group (50.3% vs. 30.9%, p = 0.01). The 5-year overall survival rate was 72.6% in adjuvant chemotherapy group and 57.2% in no adjuvant chemotherapy group (p = 0.09). With patients with the negative margin (n = 1596), the 5-year RFS rate did not show any difference between two groups (75.6% vs. 76.8%, p = 0.94). On multivariate analysis, adjuvant chemotherapy was significantly associated with RFS in patients who had the positive surgical margin (Hazard ratio (HR): 0.48, 95% confidence interval (CI): 0.25-0.94, p = 0.032). In contrast, there was no significant association between adjuvant chemotherapy and RFS in those with negative surgical margin (HR: 0.99, 95% CI: 0.72-1.35, p = 0.94).
Conclusions
Patients who received adjuvant chemotherapy showed a significantly improved 5-year RFS rate compared with those who did not receive adjuvant chemotherapy if the patients had positive surgical margin. The benefit of adjuvant chemotherapy was more remarkable in patients with positive surgical margin compared to those with negative surgical margin.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
15P - Comparing the outcomes of the mastectomy using the tumescent technique by between the special and non-special surgeons
Presenter: Naoya Takeda
Session: Poster display session
Resources:
Abstract
16P - Risk factors and prognostic value of non-alcoholic fatty liver disease (NAFLD) in hormone positive, non-metastatic breast cancer receiving adjuvant hormonal therapy
Presenter: Kartika Taroeno Hariadi
Session: Poster display session
Resources:
Abstract
17P - Distance related outcome in indigenous and non-indigenous breast cancer women of Western Australia
Presenter: Azim Khan
Session: Poster display session
Resources:
Abstract
18P - Usefulness of neutrophil to lymphocyte ratio in early stage breast cancer as predictor of disease-free survival in a Babylon Oncology Center
Presenter: Yaala Raof Al-Bairmany
Session: Poster display session
Resources:
Abstract
19P - Silymarin functionalized quantum cores as selective inhibitor of polo-like kinase 1, and preclinical antitumor activity in human breast cancer xenografts
Presenter: Manickam Paulpandi
Session: Poster display session
Resources:
Abstract
20P - Diagnostic value of serum HER-2 level in compression with tissue HER-2 in breast cancer: A systematic review and meta-analysis
Presenter: Amir Shamshirian
Session: Poster display session
Resources:
Abstract
21P - Clinical outcome of treatment without trastuzumab in HER2 positive breast cancer patients
Presenter: Than Than Aye
Session: Poster display session
Resources:
Abstract
22P - Clinical outcomes after skin-sparing or nipple areolar complex-sparing mastectomy with sentinel lymph node biopsy in early breast cancer patients
Presenter: Hye Yoon Lee
Session: Poster display session
Resources:
Abstract
23P - The correlations between knowledge and attitudes of productive age women toward “SADARI” (breast self-assessment) as early detection of breast cancer in Pejeng Kaja Village, Ubud, Bali
Presenter: Yorky Brahmantya
Session: Poster display session
Resources:
Abstract
24TiP - KEYNOTE-756: A randomized, double-blind, phase III study of pembrolizumab or placebo with neoadjuvant chemotherapy and adjuvant endocrine therapy for high-risk, early-stage, ER+/HER2−breast cancer
Presenter: Fatima Cardoso
Session: Poster display session
Resources:
Abstract