Title :

Does A Longer Waiting Period After Neoadjuvant Radio-chemotherapy Improve the Oncological Prognosis of Rectal Cancer?

Author(s) :

Lefèvre, Jérémie [Auteur]
Institut Charles Gerhardt Montpellier - Institut de Chimie Moléculaire et des Matériaux de Montpellier [ICGM]
Mineur, Laurent [Auteur]
Institut Sainte Catherine [Avignon]
Cachanado, Marine [Auteur]
CHU Saint-Antoine [AP-HP]
Denost, Quentin [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Rouanet, Philippe [Auteur]
Institut régional de Cancérologie de Montpellier [ICM]
de Chaisemartin, Cécile [Auteur]
Institut Paoli-Calmettes [IPC]
Meunier, Bernard [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Mehrdad, Jafari [Auteur]
Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] [UNICANCER/Lille]
Cotte, Eddy [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Desrame, Jérome [Auteur]
Hôpital privé Jean Mermoz [Lyon]
Karoui, Mehdi [Auteur]
Sorbonne Université [SU]
CHU Pitié-Salpêtrière [AP-HP]
Benoist, Stéphane [Auteur]
Kirzin, Sylvain [Auteur]
Chirurgie Générale et Digestive [Purpan]
Berger, Anne [Auteur]
Service de chirurgie digestive, générale et cancérologique [CHU HEGP]
Panis, Yves [Auteur]
Piessen, Guillaume [Auteur]
Hôpital Claude Huriez [Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Saudemont, Alain [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Prudhomme, Michel [Auteur]
Peschaud, Frédérique [Auteur]
Hôpital Ambroise Paré [AP-HP]
Université Paris-Saclay
Dubois, Anne [Auteur]
CHU Clermont-Ferrand
Loriau, Jérome [Auteur]
Tuech, Jean-Jacques [Auteur]
Meurette, Guillaume [Auteur]
Lupinacci, Renato [Auteur]
Goasguen, Nicolas [Auteur]
Creavin, Ben [Auteur]
Simon, Tabassome [Auteur]
Parc, Yann [Auteur]

Journal title :

Annals of Surgery

Pages :

747-754

Publisher :

Lippincott, Williams & Wilkins

Publication date :

2019-11

ISSN :

0003-4932

HAL domain(s) :

Sciences du Vivant [q-bio]/Cancer

English abstract : [en]

Objective: The aim of this study was to report the 3-year survival results of the GRECCAR-6 trial. Summary Background Data: Current data on the effect of an extended interval between radiochemotherapy (RCT) and resection ...
Show more >Objective: The aim of this study was to report the 3-year survival results of the GRECCAR-6 trial. Summary Background Data: Current data on the effect of an extended interval between radiochemotherapy (RCT) and resection for rectal cancer on the rate of complete pathological response (pCR = ypT0N0) is controversial. Furthermore, its effect on oncological outcomes is unknown. Methods: The GRECCAR-6 trial was a phase III, multicenter, randomized, open-label, parallel-group, controlled trial. Patients with cT3/T4 or TxN+ tumors of the mid or lower rectum who had received RCT (45–50 Gy with 5-fluorouracil or capecitabine) were included and randomized into a 7- or 11-week waiting period. Primary endpoint was the pCR rate. Secondary endpoints were 3-year overall (OS), disease-free survival (DFS), and recurrence rates. Results: A total of 265 patients from 24 participating centers were enrolled. A total of 253 patients underwent a mesorectal excision. Overall pCR rate was 17% (43/253). Mean follow-up from surgical resection was 32 ± 8 months. Twenty-four deaths occurred with an 89% OS at 3 years. DFS was 68.7% at 3 years (75 recurrences). Three-year local and distant recurrences were 7.9% and 23.8%, respectively. The randomization group had no impact on the 3-year OS ( P = 0.8868) or DFS ( P = 0.9409). Distant ( P = 0.7432) and local ( P = 0.3944) recurrences were also not influenced by the waiting period. DFS was independently influenced by 3 factors: circumferential radial margin (CRM) ≤1 mm [hazard ratio (HR) = 2.03; 95% confidence interval (CI), 1.17–3.51], ypT3-T4 (HR = 2.69; 95% CI, 1.19–6.08) and positive lymph nodes (HR = 3.62; 95% CI, 1.89–6.91). Conclusion: Extending the waiting period by 4 weeks following RCT has no influence on the oncological outcomes of T3/T4 rectal cancers.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL