- Total neoadjuvant therapy (TNT) does not appear to provide a survival benefit over neoadjuvant chemoradiation therapy (nCRT) in locally advanced rectal cancer.
Why this matters
- 2:1 propensity-matched analysis (372 TNT, 707 nCRT).
- TNT consisted of multiagent induction chemotherapy ≥2 months before radiotherapy, followed by preoperative CRT and no adjuvant chemotherapy.
- nCRT consisted of preoperative radiotherapy and chemotherapy initiated within 2 weeks of one another, followed by surgery with or without adjuvant chemotherapy.
- Funding: None.
- TNT and nCRT were associated with a similar OS Kaplan-Meier curve (P=.16).
- 5-year OS did not reach statistical significance (78.5% vs 73.6%; P=.20).
- Multivariable Cox proportional hazards regression showed no association between OS and TNT vs nCRT (HR, 1.21; P=.25).
- TNT was associated with numerically higher pathologic complete response rate, but did not reach statistical significance (16.9% vs 13.1%; P=.12).
- Multivariate logistic regression modeling showed no statistically significant association between TNT and pathological complete response (OR, 1.36; P=.13) or circumferential resection margin (OR, 1.77; P=.19).
- Retrospective analysis.