Rectal cancer: successful neoadjuvant CRT may obviate need for adjuvant therapy

  • Sci Rep

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • In meta-analysis, adjuvant chemotherapy (ACT) failed to yield significant survival benefit among patients with a pathological complete response to neoadjuvant chemoradiotherapy (CRT) for rectal cancer.

Why this matters

  • ACT is generally recommended after transabdominal surgery, but the advent of neoadjuvant CRT has brought its utility into question.

Study design

  • Meta-analysis of 13 studies, including 4 pooled analyses (group 1, n=3182; group 2, n=3330; group 3, n=3575; group 4, n=4739).
  • Funding: Korean government.

Key results

  • There was a trend toward better OS with ACT, but it did not reach statistical significance (group 1 HR, 0.72 [P=.09]; group 2 HR, 0.71 [P=.03]; group 3 HR, 0.72 [P=.12]; group 4 HR, 0.76 [P=.10]).
  • There was no significant heterogeneity between the groups.
  • Stratified analyses showed no significant survival benefit associated with ACT in multicenter (HR, 0.68; P=.12) or single-institution (HR, 0.90; P=.81) studies.
  • There was no evidence of publication bias in the overall pooled results.

Limitations

  • All included studies were observational.