Mid-term oncologic outcome of a novel approach for locally advanced colon cancer with neoadjuvant chemotherapy and surgery

被引:65
作者
Arredondo, J. [1 ]
Baixauli, J. [2 ]
Pastor, C. [3 ]
Chopitea, A. [4 ]
Sola, J. J. [5 ]
Gonzalez, I. [6 ]
A-Cienfuegos, J. [2 ]
Martinez, P. [7 ]
Rodriguez, J. [4 ]
Hernandez-Lizoain, J. L. [2 ]
机构
[1] Complejo Asistencial Univ Leon, Dept Gen Surg, C Altos de Nava S-N, Leon 24008, Spain
[2] Univ Navarra Clin, Dept Gen Surg, Pamplona, Spain
[3] Fdn Jimenez Diaz, Dept Gen Surg, Madrid, Spain
[4] Univ Navarra Clin, Dept Med Oncol, Pamplona, Spain
[5] Hosp San Pedro, Dept Pathol, Logrono, Spain
[6] Univ Navarra Clin, Dept Radiol, Pamplona, Spain
[7] Ctr Med Asturias, Dept Gen Surg, Oviedo, Spain
关键词
Preoperative chemotherapy; Oxaliplatin; Fluoropyrimidines; Tumor response; Survival; COMPUTED-TOMOGRAPHY; COLORECTAL-CANCER; RECTAL-CANCER; SURVIVAL; CHEMORADIOTHERAPY; RECOMMENDATIONS; CARCINOMA; PROTOCOL; IMPACT; TRIAL;
D O I
10.1007/s12094-016-1539-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Neoadjuvant chemotherapy is being actively tested as an emerging alternative for the treatment of locally advanced colon cancer (LACC) patients, resembling its use in other gastrointestinal tumors. This study assesses the mid-term oncologic outcome of LACC patients treated with oxaliplatin and fluoropyrimidines-based preoperative chemotherapy followed by surgery. Patients with radiologically resectable LACC treated with neoadjuvant therapy between 2009 and 2014 were retrospectively analyzed. Radiological, metabolic, and pathological tumor response was assessed. Both postoperative complications, relapse-free survival (RFS), and overall survival (OS) were studied. Sixty-five LACC patients who received treatment were included. Planned treatment was completed by 93.8 % of patients. All patients underwent surgery without delay. The median time between the start of chemotherapy and surgery was 71 days (65-82). No progressive disease was observed during preoperative treatment. A statistically significant tumor volume reduction of 62.5 % was achieved by CT scan (39.8-79.8) (p < 0.001). It was also observed a median reduction of 40.5 % (24.2-63.7 %) (p < 0.005) of SUVmax (Standard Uptake Value) by PET-CT scan. Complete pathologic response was achieved in 4.6 % of patients. Postoperative complications were observed in 15.4 % of patients, with no cases of mortality. After a median follow-up of 40.1 months, (p (25)-p (75): 27.3-57.8) 3-5 year actuarial RFS was 88.9-85.6 %, respectively. Five-year actuarial OS was 95.3 %. Preoperative chemotherapy in LACC patients is safe and able to induce major tumor regression. Survival times are encouraging, and further research seems warranted.
引用
收藏
页码:379 / 385
页数:7
相关论文
共 25 条
[11]  
Edge S.B., 2010, AJCC cancer staging manual, V649
[12]   Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008 [J].
Ferlay, Jacques ;
Shin, Hai-Rim ;
Bray, Freddie ;
Forman, David ;
Mathers, Colin ;
Parkin, Donald Maxwell .
INTERNATIONAL JOURNAL OF CANCER, 2010, 127 (12) :2893-2917
[13]   Preoperative chemosensitivity testing as Predictor of Treatment benefit in Adjuvant stage III colon cancer (PePiTA): Protocol of a prospective BGDO (Belgian Group for Digestive Oncology) multicentric study [J].
Hendlisz, Alain ;
Golfinopoulos, Vassilis ;
Deleporte, Amelie ;
Paesmans, Marianne ;
El Mansy, Hazem ;
Garcia, Camilo ;
Peeters, Marc ;
Annemans, Lieven ;
Vandeputte, Caroline ;
Maetens, Marion ;
Borbath, Ivan ;
Dresse, Damien ;
Houbiers, Ghislain ;
Fried, Michael ;
Awada, Ahmad ;
Piccart, Martine ;
Van Laethem, Jean-Luc ;
Flamen, Patrick .
BMC CANCER, 2013, 13
[14]   Surgical Complications Are Associated With Omission of Chemotherapy for Stage III Colorectal Cancer [J].
Hendren, Samantha ;
Birkmeyer, John D. ;
Yin, Huiying ;
Banerjee, Mousumi ;
Sonnenday, Christopher ;
Morris, Arden M. .
DISEASES OF THE COLON & RECTUM, 2010, 53 (12) :1587-1593
[15]   Prognostic value of preoperative radiological staging assessed by computed tomography in patients with nonmetastatic colon cancer [J].
Huh, J. W. ;
Jeong, Y. Y. ;
Kim, H. R. ;
Kim, Y. J. .
ANNALS OF ONCOLOGY, 2012, 23 (05) :1198-1206
[16]   Lymph node evaluation in stage IIA colorectal cancer and its impact on patient prognosis: A population-based study [J].
Iachetta, Francesco ;
Bonetti, Luca Reggiani ;
Marcheselli, Luigi ;
Di Gregorio, Carmela ;
Cirilli, Claudia ;
Messinese, Simona ;
Cervo, Gian L. ;
Postiglione, Raffaella ;
Di Emidio, Katia ;
Pedroni, Monica ;
Longinotti, Ernesto ;
Federico, Massimo ;
de Leon, Maurizio Ponz .
ACTA ONCOLOGICA, 2013, 52 (08) :1682-1690
[17]   Survival Paradox Between Stage IIB/C (T4N0) and Stage IIIA (T1-2N1) Colon Cancer [J].
Kim, Min Jung ;
Jeong, Seung-Yong ;
Choi, Sang-ji ;
Ryoo, Seung-Bum ;
Park, Ji Won ;
Park, Kyu Joo ;
Oh, Jae Hwan ;
Kang, Sung-Bum ;
Park, Hyoung-Chul ;
Heo, Seung Chul ;
Park, Jae-Gahb .
ANNALS OF SURGICAL ONCOLOGY, 2015, 22 (02) :505-512
[18]   Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data [J].
Maas, Monique ;
Nelemans, Patty J. ;
Valentini, Vincenzo ;
Das, Prajnan ;
Roedel, Claus ;
Kuo, Li-Jen ;
Calvo, Felipe A. ;
Garcia-Aguilar, Julio ;
Glynne-Jones, Rob ;
Haustermans, Karin ;
Mohiuddin, Mohammed ;
Pucciarelli, Salvatore ;
Small, William, Jr. ;
Suarez, Javier ;
Theodoropoulos, George ;
Biondo, Sebastiano ;
Beets-Tan, Regina G. H. ;
Beets, Geerard L. .
LANCET ONCOLOGY, 2010, 11 (09) :835-844
[19]   Chemotherapy before surgery for colon cancer may improve survival, study shows [J].
Mayor, Susan .
BMJ-BRITISH MEDICAL JOURNAL, 2012, 345
[20]   Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial [J].
Morton, U. K. Dion ;
Seymour, Matt ;
Magill, Laura ;
Handley, Kelly ;
Brown, Gina ;
Ferry, David ;
West, Nick ;
Quirke, Philip ;
Warren, Bryan ;
Gray, Richard .
LANCET ONCOLOGY, 2012, 13 (11) :1152-1160