Abstract 4109
Background
Neoadjuvant chemoradiotherapy (CRT) is a standard treatment for patients with locally advanced rectal cancer and is effective as a palliative care in patients with nonresectable tumors. Unfortunately CRT is often being withheld for patients with tumor-associated complications due to safety concerns. Literature search reveals only case reports and neither supports nor declines additional risks of CRT in this patient group. The aim of this study was to determine feasibility of CRT in rectal cancer with peritumoral abscesses and fistulas.
Methods
Patients with locally advanced or recurrent rectal cancer with peritumoral abscesses and fistulas were included in the study group. The control group consisted of T4 locally advanced or recurrent rectal cancer patients without complications, both groups received long-course neoadjuvant CRT. Groups were matched by age, previous treatment, treatment year. The primary endpoint was CRT toxicity. Secondary endpoints included postoperative morbidity (Clavien-Dindo), pathologic complete response (pCR) and 2year PFS.
Results
30 patients were included in each group. Patients in the main group had following tumor-associated complications: perianal fistula (n = 11), abdominal wall fistula (n = 1), rectovaginal fistula (n = 9), rectovesical fistula (n = 4), peritumoral abscess (n = 17). Grade 3-4 toxicity was observed in 2 (6.66%) vs 3 (10%) patients, non-inferiority was confirmed (p = 0.0326). Grade 3-4 postoperative complications were observed in 2 (7.14%) patients in the main group and in 3 (10.7%) patients in the control group (p = 0.639) with no cases of mortality. pCR was achieved in 2 (7.14%) and 5 (17.8%) patients accordingly (p = 0.225). Median follow-up was 25.2 months in the main group and 27.4 months in the control group. Two-year OS was 69% vs 100% (p = 0.11), 2-year PFS was 65% vs 78% (p = 0.434).
Conclusions
Peritumoral abscesses and fistulas should not be considered as contraindication to neoadjuvant chemoradiotherapy. CRT is feasible and safe in patients with tumor-associated complications.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3608 - Prognostic impact of Body Mass Index (BMI) on overall survival in patients with metastatic breast cancer
Presenter: Khalil SALEH
Session: Poster Display session 2
Resources:
Abstract
2686 - Clinicopathological characteristics, survival and prognostic factors of breast cancer-related microangiopathic haemolytic anemia: a multicenter study
Presenter: Marion Alhenc Gelas
Session: Poster Display session 2
Resources:
Abstract
1565 - Metabolic tumor volume by 18F-FDG PET/CT is an independent prognostic factor in metastatic breast cancer
Presenter: Heekyung Ahn
Session: Poster Display session 2
Resources:
Abstract
4498 - Patient Preferences for breast cancer treatments: A Discrete Choice Experiment from four European countries
Presenter: Thomais Konstantopoulou
Session: Poster Display session 2
Resources:
Abstract
1423 - Palbociclib plus fulvestrant as second- or later-line therapy for patients with locally advanced, inoperable or metastatic HR+/HER2- breast cancer in Germany: Interim results of the INGE-B phase 2 study
Presenter: Diana Lüftner
Session: Poster Display session 2
Resources:
Abstract
2284 - Ventriculoperitoneal Shunt for CNS Metastasis in Breast Cancer: Clinical Outcomes Based on Intrinsic Subtype
Presenter: Hee Kyung Kim
Session: Poster Display session 2
Resources:
Abstract
4598 - Administration of chemotherapy for metastatic breast cancer near the end of life: a population registry study
Presenter: Luisa Edman Kessler
Session: Poster Display session 2
Resources:
Abstract
5706 - Prognostic value of histological growth pattern in patients operated for breast cancer liver metastases
Presenter: Ali Bohlok
Session: Poster Display session 2
Resources:
Abstract
1697 - Illness perceptions, quality of life and mood in metastatic breast cancer patients
Presenter: Isabel Domingues
Session: Poster Display session 2
Resources:
Abstract
1935 - Multidisciplinary Treatments Increases Overall Survival in Patients with Newly Diagnosed Stage IV Breast Cancer:An Analysis of 2010–2014 SEER Data
Presenter: Jian Zhang
Session: Poster Display session 2
Resources:
Abstract