Clinical outcome in patients who did not accept complementary surgery after neoadjuvant chemoradiotherapy (QT-RT) in locally advanced rectal cancer (LARC).

Abstract

e15144Background: In patients with LARC the neoadjuvant concurrent chemoradiotherapy (CRT) follow by radical surgery is the standard approach. Approximately 15-20% achieve pathologic complete remission (pCR) after CRT. The morbidity, mortality, risk of permanent colostomy and other factors are the main reasons to refuse the surgical procedure. The evolution of these patients is uncertain. The aim of the present analysis is to determinate the benefit of observation in these patients. Methods: This is a retrospective study of patients with LARC who completed neoadjuvant CRT and refused radical surgery. Results: Between 2000 and 2014, 413 patients with LARC adenocarcinoma were treated with neoadjuvant CRT, of these, 248 were men and 165 women. All patients received 45-50.4 Gys concurrent with fluoropyrimidine based chemotherapy and only 14 patients received fluoropyrimidine with oxaliplatin. After clinical, tomographic, endoscopic and histological evaluation the patients were candidates for radical surgery. ...