- In patients with nonmetastatic rectal cancer who achieved a complete clinical response (cCR) to neoadjuvant chemoradiation therapy (nCRT), 5-year surgery-free and distant metastasis-free survival (DMFS) were similar in node-positive and node-negative patients.
Why this matters
- There is concern that node-positive patients may be at increased risk for local regrowth, more advanced disease at time of recurrence, and poorer DMFS.
- Retrospective analysis of 335 patients who underwent nCRT.
- Median follow-up, 55 months.
- Funding: None.
- No pretreatment factors were associated with risk for local recurrence after achieving cCR.
- 117 patients were node-positive and 218 were node-negative at baseline.
- 62 node-positive patients (53.0%) and 135 node-negative patients (61.9%) achieved cCR and were managed nonoperatively.
- Node-positive vs node-negative:
- 5-year cancer-specific survival (83.9% vs 84.5%; P=.99).
- DMFS (77.5% vs 80.5%; P=.49).
- Surgery-free survival (39.7% vs 46.8%; P=.20).
- When the analysis was restricted to patients who achieved cCR and were managed with watchful waiting, the differences were still nonsignificant:
- 5-year overall cancer-specific survival (90.3% vs 90.9%; P=.86).
- Distant metastases-free survival (88.2% vs 88.6%; P=.92).
- Surgery-free survival (76% vs 75.8%; P=.88).
- Retrospective analysis.
- Small sample size.
- Single institution.