Systematic review and meta-analysis of outcomes following pathological complete response to neoadjuvant chemoradiotherapy for rectal cancer

The British Journal of Surgery
S T MartinD C Winter

Abstract

Following neoadjuvant chemoradiotherapy (CRT) and interval proctectomy, 15-20 per cent of patients are found to have a pathological complete response (pCR) to combined multimodal therapy, but controversy persists about whether this yields a survival benefit. This systematic review evaluated current evidence regarding long-term oncological outcomes in patients found to have a pCR to neoadjuvant CRT. Three major databases (PubMed, MEDLINE and the Cochrane Library) were searched. The systematic review included all original articles reporting long-term outcomes in patients with rectal cancer who had a pCR to neoadjuvant CRT, published in English, from January 1950 to March 2011. A total of 724 studies were identified for screening. After applying inclusion and exclusion criteria, 16 studies involving 3363 patients (1263 with pCR and 2100 without) were included (mean age 60 years, 65·0 per cent men). Some 73·4 per cent had a sphincter-saving procedure. Mean follow-up was 55·5 (range 40-87) months. For patients with a pCR, the weighted mean local recurrence rate was 0·7 (range 0-2·6) per cent. Distant failure was observed in 8·7 per cent. Five-year overall and disease-free survival rates were 90·2 and 87·0 per cent respectively. Comp...Continue Reading

References

May 1, 1982·The British Journal of Surgery·P A HurstR T Walker
Sep 1, 1993·International Journal of Colorectal Disease·J P BarrasP Aeberhard
Nov 15, 1997·The British Journal of Surgery·N R Ahmad, D Nagle
Jun 2, 1998·The British Journal of Surgery·E CarlsenR J Heald
Mar 3, 2001·Diseases of the Colon and Rectum·F Lopez-KostnerI C Lavery
May 31, 2001·International Journal of Radiation Oncology, Biology, Physics·J SeongC O Suh
Dec 14, 2001·Diseases of the Colon and Rectum·J Garcia-AguilarD A Rothenberger
Jan 5, 2002·Annals of Surgical Oncology·M W OnaitisD S Tyler
Feb 19, 2002·Journal of the American College of Surgeons·Spiros P HiotisW Douglas Wong
May 25, 2002·Journal of the American College of Surgeons·Scott R SchellEdward M Copeland
Apr 5, 2003·Annals of Surgery·Dieter HahnloserAlan Horgan
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Jan 30, 2004·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Isabelle BedrosianJohn M Skibber
Apr 27, 2004·Diseases of the Colon and Rectum·Thomas E ReadIra J Kodner
Oct 22, 2004·The New England Journal of Medicine·Rolf SauerUNKNOWN German Rectal Cancer Study Group
Nov 3, 2004·International Journal of Radiation Oncology, Biology, Physics·Mark BonnenBarry W Feig
Feb 15, 2005·International Journal of Radiation Oncology, Biology, Physics·Alexander K P ChanDouglas Johnson
Jun 4, 2005·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·E MooreB J Moran
Oct 26, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Claus RödelChristian Wittekind
Feb 1, 2006·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Mohammed MohiuddinUNKNOWN Radiation Therapy Oncology Group Trial 0012
Dec 19, 2006·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Angelita Habr-GamaJoaquim Gama-Rodrigues
Oct 2, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Laurence ColletteUNKNOWN European Organisation for Research and Treatment of Cancer Radiation Oncology Group
Apr 15, 2008·International Journal of Radiation Oncology, Biology, Physics·Carlo CapirciGiuseppe La Torre
Aug 19, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Rajesh M NairDavid Shibata
Apr 1, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Annelies DebucquoyJean-Pascal Machiels
Jul 2, 2009·ANZ Journal of Surgery·Anthony CiccocioppoNicholas A Rieger
Jul 23, 2009·BMJ : British Medical Journal·David MoherUNKNOWN PRISMA Group
Sep 23, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Mark S RohNorman Wolmark
Jan 26, 2010·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·M KustersG L Beets

❮ Previous
Next ❯

Citations

Sep 11, 2013·Journal of Visceral Surgery·C LartigauA Alves
Apr 25, 2014·Gastroenterology Report·Mario Morino, Marco E Allaix
Apr 23, 2013·Annals of Surgical Oncology·Marco E Allaix, Alessandro Fichera
May 15, 2013·Annals of Surgical Oncology·H M MohanD C Winter
Jan 15, 2014·International Journal of Colorectal Disease·Mikaela L GarlandIan P Bissett
Feb 4, 2014·Best Practice & Research. Clinical Gastroenterology·Christopher J SmartSimon P Bach
Nov 5, 2013·International Journal of Surgical Oncology·Marisa D SantosCarlos Lopes
Jan 22, 2013·Updates in Surgery·G MelottiA Minicozzi
Dec 15, 2015·Expert Review of Anticancer Therapy·Subotheni Thavaneswaran, Timothy J Price
Nov 26, 2015·Cancer·Jordan A TorokBrian G Czito
Mar 18, 2015·Cancer Research and Treatment : Official Journal of Korean Cancer Association·Jaesung HeoOyeon Cho
Dec 15, 2015·The British Journal of Surgery·R W RadwanUNKNOWN Swansea Pelvic Oncology Group
Nov 8, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Christian P ProbstFergal J Fleming
Aug 12, 2015·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J E RyanA G Heriot
Dec 3, 2015·Clinical Oncology : a Journal of the Royal College of Radiologists·R Glynne-Jones, R Hughes
Nov 5, 2015·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Jennifer E RyanAlexander G Heriot
Jun 30, 2015·The Keio Journal of Medicine·Yoko Fujii-NishimuraYuko Kitagawa
Dec 4, 2015·ANZ Journal of Surgery·Melanie J McCoyCameron F Platell
Mar 29, 2013·The British Journal of Surgery·D A M SloothaakUNKNOWN Dutch Surgical Colorectal Audit
Feb 7, 2013·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·W SunW Shen
Nov 14, 2012·The British Journal of Surgery·R P KennellyUNKNOWN Abdominoperineal Excision Study Group
Nov 21, 2012·The British Journal of Surgery·M AdaminaF Ris
May 13, 2014·The British Journal of Surgery·H OrtizUNKNOWN Spanish Rectal Cancer Project
Jan 27, 2015·The British Journal of Surgery·E EspínUNKNOWN Spanish Rectal Cancer Project
Sep 17, 2013·The Journal of Pathology·Iris D NagtegaalPhil Quirke
May 6, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·P LoftåsO Hallböök
Aug 19, 2015·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·V VendrelyÉ Rullier

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.