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The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study

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Tumor Biology

Abstract

Rectal cancer, defined as a cancerous lesion of the colon distal to the rectosigmoid junction, is the fourth most common cancer cause of death globally. There were 474 patients with rectal cancer who underwent surgery between October 2007 and May 2013 enrolled in our center. Patients were respectively categorized by neoadjuvant therapy. This study aimed to explore the predictive factors that affected the Progression-free survival and overall survival of the patients with rectal cancer. Clinical characteristics of patients were compared with the groups and potential prognostic factors were analyzed by SPSS 19.0. In our study, neoadjuvant therapy increased the anus-retained rate (64.4 vs 53.4 % P = 0.016) and remission rate in the treatment group, compared to the non-treatment group (62.6 vs 34.8 %; P = 0.000). The neoadjuvant concurrent chemoradiotherapy, more operative duration, anus retained and micturition damaged are positive prognostic factors of PFS to patients. Poor differentiation, the tumor of ulcer, invasive, and pT4 stage, contributed the poor factors for PFS of patients (P < 0.05). Additionally, the patients with neoadjuvant concurrent chemoradiotherapy and adjuvant chemotherapy underwent the better prognosis of OS. Adjuvant chemotherapy cannot increase PFS of the patients who accepted neoadjuvant therapy after surgery get pCR, but can improve OS. The anus-retained and neoadjuvant radiotherapy, duration of surgery in rectal cancer have the positive correlation. Micturition damaged and neoadjuvant radiotherapy were positively correlated as well. In conclusion, adjuvant chemotherapy does not improve the PFS of patients with pCR to neoadjuvant therapy, but is good for OS. Further prospective and large population-based clinical studies are needed to establish clinical guidelines for the use of neoadjuvant therapy and adjuvant chemotherapy in patients with rectal cancer.

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Acknowledgments

This work was supported by grants from the National Natural Science Foundations of China (nos. 81171904 and 81401412). We thank all the people and patients who participated in this study.

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    Authors and Affiliations

    1. Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China

      Qing Li, Yu Peng, Meng-Xia Li, Yi Qing, Wei Xia & Dong Wang

    2. Department of Rehabilitation Medicine, Center of Bone Metabolism and Repair, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042, China

      Lin-Ang Wang

    3. Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China

      Xi Wei

    4. Gastrointestinal Surgery, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China

      Chun-Xue Li

    5. Department of Sport Medicine, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, 330006, China

      Ming Cheng

    6. Department of Obstetrics and Gynecology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, China

      Dan Zi

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    1. Qing Li
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    Correspondence to Chun-Xue Li or Dong Wang.

    Additional information

    Corresponding authors Chun-Xue Li and Dong Wang contributed equally to this work.

    Qing Li, Yu Peng, Lin-Ang Wang and Xi Wei contributed equally to this work.

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    Li, Q., Peng, Y., Wang, LA. et al. The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study. Tumor Biol. 37, 3441–3449 (2016). https://doi.org/10.1007/s13277-015-4153-0

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    • DOI: https://doi.org/10.1007/s13277-015-4153-0

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