- Patients with stage II-III rectal adenocarcinoma who achieved a complete clinical response (cCR) after chemoradiation (CRT) without surgery had similar OS and disease-specific survival (DSS) as patients who underwent CRT and surgery.
Why this matters
- Nonoperative management of rectal cancer is growing in practice, in part because of the high rate of postoperative complications, but long-term data on oncologic outcomes were lacking.
- 1313 patients with stage II-III rectal adenocarcinoma from the VA Central Cancer Registry underwent concurrent chemoradiation (CRT) with (n=1000) or without (n=313) subsequent surgery.
- Funding: None disclosed.
- Median OS was significantly longer for the surgical group compared with CRT alone (89.3 vs 30.6 months; HR, 0.366; P<.001>
- Median DSS was not reached in the surgery group and was significantly longer than in the CRT-alone group (HR, 0.311; P<.001>
- 20.8% of CRT-alone patients achieved cCR.
- Median OS for CRT patients who achieved cCR was 73.5 months and was not significantly different than median OS of patients who received CRT plus surgery (HR, 0.786; 95% CI, 0.576-1.072).
- Median DSS was not reached for cCR patients and was not significantly different than the median DSS for the CRT plus surgery patients (HR, 1.572; 95% CI, 0.826-2.957).
- Retrospective study.