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
3963 - Robot-assisted natural orifice specimen extraction surgery for radical resection of colorectal cancer
Presenter: Zhengchuan Niu
Session: Poster Display session 2
Resources:
Abstract
3989 - Bevacizumab as adjuvant treatment for colon cancer: Updated results from the AVANT phase III Study by the GERCOR Group
Presenter: Thierry André
Session: Poster Display session 2
Resources:
Abstract
4741 - Real world data on adjuvant chemotherapy for high-risk stage II colorectal cancer – the role of tumor side
Presenter: Camila Araujo de Carvalho
Session: Poster Display session 2
Resources:
Abstract
4973 - Oncological Outcome and Safety of Bevacizumab (BV) Therapy in Patients with Occlusive Colon Cancer and Self-Expandable Metal Stents (SEMS)
Presenter: Vilma Pacheco-Barcia
Session: Poster Display session 2
Resources:
Abstract
2295 - Active chronic hepatitis B increases the risk of liver metastasis of colorectal cancer- a retrospective clinical study of 7187 consecutive cases of newly diagnosed colorectal cancer
Presenter: Lei Zhao
Session: Poster Display session 2
Resources:
Abstract
3845 - Comprehensive Evaluation of Recurrence Risk (CERR) Score for Colorectal Liver Metastases: Development and Validation
Presenter: Wei Ye
Session: Poster Display session 2
Resources:
Abstract
1976 - BRAF-mutated colorectal metastases: what is the benefit of liver surgery? Results from a cohort of 91 patients.
Presenter: Sahir Javed
Session: Poster Display session 2
Resources:
Abstract
2688 - The smallest colorectal liver metastasis size as a prognosis factor after laparoscopic liver resection
Presenter: Baptiste Cervantes
Session: Poster Display session 2
Resources:
Abstract
4961 - Validation of GAME score risk groups in resected colorectal cancer liver metastases and the prognostic relevance of KRAS, NRAS and BRAF mutation analysis
Presenter: Berta Martin-Cullell
Session: Poster Display session 2
Resources:
Abstract
5295 - Predictive factors and survival outcomes with stereotactic body radiation therapy in treatment of oligometastases in colorectal cancer
Presenter: Vibhay Pareek
Session: Poster Display session 2
Resources:
Abstract