Early and late morbidity of local excision after chemoradiotherapy for rectal cancer
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd..
BACKGROUND: Local excision (LE) after chemoradiotherapy is a new option in low rectal cancer, but morbidity has never been compared prospectively with total mesorectal excision (TME). Early and late morbidity were compared in patients treated either by LE or TME after neoadjuvant chemoradiotherapy for rectal cancer.
METHOD: This was a post-hoc analysis from a randomized trial. Patients with clinical T2/T3 low rectal cancer with good response to the chemoradiotherapy and having either LE, LE with eventual completion TME, or TME were considered. Early (1 month) and late (2 years) morbidities were compared between the three groups.
RESULTS: There were no deaths following surgery in any of the three groups. Early surgical morbidity (20 per cent LE versus 36 per cent TME versus 43 per cent completion TME, P = 0.025) and late surgical morbidity (4 per cent versus 33 per cent versus 57 per cent, P < 0.001) were significantly lower in the LE group than in the TME or the completion TME group. of LE, was associated with the lowest rate of early (10 versus 18 versus 21 per cent, P = 0.217) and late medical morbidities (0 versus 7 versus 7 per cent, P = 0.154), although this did not represent a significant difference between the groups. The severity of overall morbidity was significantly lower at 2 years after LE compared with TME or completion TME (4 versus 28 versus 43 per cent grade 3-5, P < 0.001).
CONCLUSION: The rate of surgical complications after neoadjuvant chemoradiotherapy in the LE group was half that of TME group at 1 month and 10 times lower at 2 years. LE is a safe approach for organ preservation and should be considered as an alternative to watch-and-wait in complete clinical responders and to TME in subcomplete responders.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
|---|---|
| Enthalten in: |
BJS open - 5(2021), 3 vom: 07. Mai |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Teste, B [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Completed 10.12.2021 Date Revised 31.05.2022 published: Print ClinicalTrials.gov: NCT00427375 Citation Status MEDLINE |
|---|
| doi: |
10.1093/bjsopen/zrab043 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM326452044 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM326452044 | ||
| 003 | DE-627 | ||
| 005 | 20231225194628.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/bjsopen/zrab043 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1088.xml |
| 035 | |a (DE-627)NLM326452044 | ||
| 035 | |a (NLM)34097005 | ||
| 035 | |a (PII)zrab043 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Teste, B |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Early and late morbidity of local excision after chemoradiotherapy for rectal cancer |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.12.2021 | ||
| 500 | |a Date Revised 31.05.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT00427375 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. | ||
| 520 | |a BACKGROUND: Local excision (LE) after chemoradiotherapy is a new option in low rectal cancer, but morbidity has never been compared prospectively with total mesorectal excision (TME). Early and late morbidity were compared in patients treated either by LE or TME after neoadjuvant chemoradiotherapy for rectal cancer | ||
| 520 | |a METHOD: This was a post-hoc analysis from a randomized trial. Patients with clinical T2/T3 low rectal cancer with good response to the chemoradiotherapy and having either LE, LE with eventual completion TME, or TME were considered. Early (1 month) and late (2 years) morbidities were compared between the three groups | ||
| 520 | |a RESULTS: There were no deaths following surgery in any of the three groups. Early surgical morbidity (20 per cent LE versus 36 per cent TME versus 43 per cent completion TME, P = 0.025) and late surgical morbidity (4 per cent versus 33 per cent versus 57 per cent, P < 0.001) were significantly lower in the LE group than in the TME or the completion TME group. of LE, was associated with the lowest rate of early (10 versus 18 versus 21 per cent, P = 0.217) and late medical morbidities (0 versus 7 versus 7 per cent, P = 0.154), although this did not represent a significant difference between the groups. The severity of overall morbidity was significantly lower at 2 years after LE compared with TME or completion TME (4 versus 28 versus 43 per cent grade 3-5, P < 0.001) | ||
| 520 | |a CONCLUSION: The rate of surgical complications after neoadjuvant chemoradiotherapy in the LE group was half that of TME group at 1 month and 10 times lower at 2 years. LE is a safe approach for organ preservation and should be considered as an alternative to watch-and-wait in complete clinical responders and to TME in subcomplete responders | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Rouanet, P |e verfasserin |4 aut | |
| 700 | 1 | |a Tuech, J-J |e verfasserin |4 aut | |
| 700 | 1 | |a Valverde, A |e verfasserin |4 aut | |
| 700 | 1 | |a Lelong, B |e verfasserin |4 aut | |
| 700 | 1 | |a Rivoire, M |e verfasserin |4 aut | |
| 700 | 1 | |a Faucheron, J-L |e verfasserin |4 aut | |
| 700 | 1 | |a Jafari, M |e verfasserin |4 aut | |
| 700 | 1 | |a Portier, G |e verfasserin |4 aut | |
| 700 | 1 | |a Meunier, B |e verfasserin |4 aut | |
| 700 | 1 | |a Sielezneff, I |e verfasserin |4 aut | |
| 700 | 1 | |a Prudhomme, M |e verfasserin |4 aut | |
| 700 | 1 | |a Marchal, F |e verfasserin |4 aut | |
| 700 | 1 | |a Dubois, A |e verfasserin |4 aut | |
| 700 | 1 | |a Capdepont, M |e verfasserin |4 aut | |
| 700 | 1 | |a Denost, Q |e verfasserin |4 aut | |
| 700 | 1 | |a Rullier, E |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t BJS open |d 2017 |g 5(2021), 3 vom: 07. Mai |w (DE-627)NLM285948415 |x 2474-9842 |7 nnns |
| 773 | 1 | 8 | |g volume:5 |g year:2021 |g number:3 |g day:07 |g month:05 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/bjsopen/zrab043 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 5 |j 2021 |e 3 |b 07 |c 05 | ||