Complete pathologic response after combined modality treatment for rectal cancer and long-term survival: A meta-analysis

Annals of Surgical Oncology

Volumn 19, Issue 9, 2012, Pages 2822-2832

  Zorcolo, Luigi ^a   Rosman, Alan S ^b   Restivo, Angelo ^a   Pisano, Michele ^c   Nigri, Giuseppe R ^d   Fancellu, Alessandro ^e   Melis, Marcovalerio ^f  

^a UNIVERSITY OF CAGLIARI   (Italy)

^b VETERANS AFFAIRS MEDICAL CENTER   (United States)

^c OSPEDALI RIUNITI   (Italy)

^d SAPIENZA UNIVERSITY OF ROME   (Italy)

^e UNIVERSITY OF SASSARI   (Italy)

^f NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CISPLATIN; FLUOROURACIL; FOLINIC ACID; MITOMYCIN C;

ABSENCE OF SIDE EFFECTS; ANUS; ARTICLE; CANCER CHEMOTHERAPY; CANCER RADIOTHERAPY; CANCER RECURRENCE; CANCER STAGING; CANCER SURVIVAL; COMPARATIVE STUDY; COMPLETE PATHOLOGIC RESPONSE; CONTINUOUS INFUSION; DISEASE FREE SURVIVAL; DISTANT METASTASIS; EXTERNAL BEAM RADIOTHERAPY; FOLLOW UP; HUMAN; LONG TERM SURVIVAL; META ANALYSIS (TOPIC); MULTIMODALITY CANCER THERAPY; OVERALL SURVIVAL; RECTUM CANCER; SAMPLE SIZE; SINGLE DRUG DOSE; SURVIVAL TIME; SYSTEMATIC REVIEW; TREATMENT RESPONSE; TUMOR LOCALIZATION; TUMOR VOLUME;

ADENOCARCINOMA; AGED; CHEMORADIOTHERAPY, ADJUVANT; CONFIDENCE INTERVALS; DISEASE-FREE SURVIVAL; FEMALE; HUMANS; MALE; MIDDLE AGED; NEOADJUVANT THERAPY; NEOPLASM RECURRENCE, LOCAL; NEOPLASM STAGING; ODDS RATIO; RECTAL NEOPLASMS; SURVIVAL RATE;

EID: 84867402398     PISSN: 10689265     EISSN: 15344681     Source Type: Journal    
DOI: 10.1245/s10434-011-2209-y     Document Type: Article

References (72)

1. Parkin DM. Global cancer statistics in the year 2000. Lancet Oncol. 2001;2:533-43.
2. Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1999. CA Cancer J Clin. 1999;49:8-31.
3. van Gijn W, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011;12:575-82.
4. Kapiteijn E, Kranenbarg EK, Steup WH, et al. Total mesorectal excision (TME) with or without preoperative radiotherapy in the treatment of primary rectal cancer. Prospective randomised trial with standard operative and histopathological techniques. Dutch ColoRectal Cancer Group. Eur J Surg. 1999;165:410-20.
5. Kapiteijn E, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001;345:638-46.
6. Gérard A, Buyse M, Nordlinger B, et al. Preoperative radiotherapy as adjuvant treatment in rectal cancer. Final results of a randomized study of the European Organization for Research and Treatment of Cancer (EORTC). Ann Surg. 1988;208:606-14.
7. Glimelius B, Grönberg H, Järhult J, Wallgren A, Cavallin-Ståhl E. A systematic overview of radiation therapy effects in rectal cancer. Acta Oncol. 2003;42:476-92.
8. Colorectal Cancer Collaborative Group. Adjuvant radiotherapy for rectal cancer: a systematic overview of 8, 507 patients from 22 randomised trials. Lancet. 2001;358:1291-304.
9. Cammà C, Giunta M, Fiorica F, Pagliaro L, Craxì A, Cottone M. Preoperative radiotherapy for resectable rectal cancer: a metaanalysis. JAMA. 2000;284:1008-15.
10. Myerson RJ, Genovesi D, Lockett MA, et al. Five fractions of preoperative radiotherapy for selected cases of rectal carcinoma: long-term tumor control and tolerance to treatment. Int J Radiat Oncol Biol Phys. 1999;43:537-43.
11. Påhlman L, Glimelius B. The value of adjuvant radio (chemo) - therapy for rectal cancer. Eur J Cancer. 1995;31 A: 1347-50.
12. Petersen S, Hellmich G, Baumann M, Herrmann T, Henke G, Ludwig K. Brief preoperative radiotherapy in surgical therapy of rectal carcinoma. Long-term results of a prospective randomized study. Chirurg. 1998;69:759-65.
13. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731-40.
14. Grann A, Feng C, Wong D, et al. Preoperative combined modality therapy for clinically resectable uT3 rectal adenocarcinoma. Int J Radiat Oncol Biol Phys. 2001;49:987-95.
15. Hartley A, Ho KF, McConkey C, Geh JI. Pathological complete response following pre-operative chemoradiotherapy in rectal cancer: analysis of phase II/III trials. Br J Radiol. 2005;78:934-8.
16. Pucciarelli S, Toppan P, Friso ML, et al. Complete pathologic response following preoperative chemoradiation therapy for middle to lower rectal cancer is not a prognostic factor for a better outcome. Dis Colon Rectum. 2004;47:1798-807.
17. Read TE, McNevin MS, Gross EK, et al. Neoadjuvant therapy for adenocarcinoma of the rectum: tumor response and acute toxicity. Dis Colon Rectum. 2001;44:513-22.
18. Uzcudun AE, Batlle JF, Velasco JC, et al. Efficacy of preoperative radiation therapy for resectable rectal adenocarcinoma when combined with oral tegafur-uracil modulated with leucovorin: results from a phase II study. Dis Colon Rectum. 2002;45:1349-58.
19. Valentini V, Coco C, Cellini N, et al. Ten years of preoperative chemoradiation for extraperitoneal T3 rectal cancer: acute toxicity, tumor response, and sphincter preservation in three consecutive studies. Int J Radiat Oncol Biol Phys. 2001;51:371-83.
20. Shivnani AT, Small W, Stryker SJ, et al. Preoperative chemoradiation for rectal cancer: results of multimodality management and analysis of prognostic factors. Am J Surg. 2007;193:389-93.
21. Clarke M. The QUORUM statement. Lancet. 2000;355:756-7.
22. Fleiss J. Statistical methods for rates and proportions. New York: Wiley-Interscience; 1981.
23. Hanley JA, Lippman-Hand A. If nothing goes wrong, is everything all right? Interpreting zero numerators. JAMA. 1983;249:1743-5.
24. Petitti D. Metaanalysis, decision analysis, and cost-effectiveness analysis: methods for quantitative synthesis in medicine.. New York: Oxford University Press; 1994. pp. 90-130.
25. Fleiss JL. The statistical basis of meta-analysis. Stat Methods Med Res. 1993;2:121-45.
26. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177-88.
27. Muncer S, Taylor S, Craigie M. Power dressing and meta-analysis: incorporating power analysis into meta-analysis. J Adv Nurs. 2002;38:274-80.
28. *Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
29. Bedrosian I, Rodriguez-Bigas MA, Feig B, et al. Predicting the node-negative mesorectum after preoperative chemoradiation for locally advanced rectal carcinoma. J Gastrointest Surg. 2004;8:56-62.
30. Burke SJ, Percarpio BA, Knight DC, Kwasnik EM. Combined preoperative radiation and mitomycin/5-fluorouracil treatment for locally advanced rectal adenocarcinoma. J Am Coll Surg. 1998;187:164-70.
31. Coco C, Valentini V, Manno A, et al. Long-term results after neoadjuvant radiochemotherapy for locally advanced resectable extraperitoneal rectal cancer. Dis Colon Rectum. 2006;49:311-8.
32. Crane CH, Skibber JM, Birnbaum EH, et al. The addition of continuous infusion 5-FU to preoperative radiation therapy increases tumor response, leading to increased sphincter preservation in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2003;57:84-9.
33. Janjan NA, Crane C, Feig BW, et al. Improved overall survival among responders to preoperative chemoradiation for locally advanced rectal cancer. Am J Clin Oncol. 2001;24:107-12.
34. Onaitis M, Noone R, Fields R, et al. Complete response to neoadjuvant chemoradiation for rectal cancer does not influence survival. Ann Surg Oncol. 2001;8:801-6.
35. Rich TA, Skibber JM, Ajani JA, et al. Preoperative infusional chemoradiation therapy for stage T3 rectal cancer. Int J Radiat Oncol Biol Phys. 1995;32:1025-9.
36. Quah HM, Chou JF, Gonen M, et al. Pathologic stage is most prognostic of disease-free survival in locally advanced rectal cancer patients after preoperative chemoradiation. Cancer. 2008;113:57-64.
37. Guillem JG, Chessin DB, Cohen AM, et al. Long-term oncologic outcome following preoperative combined modality therapy and total mesorectal excision of locally advanced rectal cancer. Ann Surg. 2005;241:829-36.
38. Brown CL, Ternent CA, Thorson AG, et al. Response to preoperative chemoradiation in stage II and III rectal cancer. Dis Colon Rectum. 2003;46:1189-93.
39. Chan AKP, Wong A, Jenken D, Heine J, Buie D, Johnson D. Posttreatment TNM staging is a prognostic indicator of survival and recurrence in tethered or fixed rectal carcinoma after preoperative chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys. 2005;61:665-77.
40. Chari RS, Tyler DS, Anscher MS, et al. Preoperative radiation and chemotherapy in the treatment of adenocarcinoma of the rectum. Ann Surg. 1995;221:778-86.
41. García-Aguilar J, Hernandez de Anda E, Sirivongs P, Lee SH, Madoff RD, Rothenberger DA. A pathologic complete response to preoperative chemoradiation is associated with lower local recurrence and improved survival in rectal cancer patients treated by mesorectal excision. Dis Colon Rectum. 2003;46:298-304.
42. Hughes R, Glynne-Jones R, Grainger J, et al. Can pathological complete response in the primary tumour following pre-operative pelvic chemoradiotherapy for T3-T4 rectal cancer predict for sterilisation of pelvic lymph nodes, a low risk of local recurrence and the appropriateness of local excision? Int J Colorectal Dis. 2006;21:11-7.
43. Kuo LJ, Liu MC, Jian JJM, et al. Is final TNM staging a predictor for survival in locally advanced rectal cancer after preoperative chemoradiation therapy? Ann Surg Oncol. 2007;14:2766-72.
44. Theodoropoulos G, Wise WE, Padmanabhan A, et al. T-level downstaging and complete pathologic response after preoperative chemoradiation for advanced rectal cancer result in decreased recurrence and improved disease-free survival. Dis Colon Rectum. 2002;45:895-903.
45. Wiig JN, Larsen SG, Dueland S, Giercksky KE. Clinical outcome in patients with complete pathologic response (pT0) to preoperative irradiation/chemo- irradiation operated for locally advanced or locally recurrent rectal cancer. J Surg Oncol. 2005;92:70-5.
46. Biondo S, Navarro M, Marti-Rague J, et al. Response to neoadjuvant therapy for rectal cancer: influence on long-term results. Colorectal Dis. 2005;7:472-9.
47. Rödel C, Martus P, Papadoupolos T, et al. Prognostic significance of tumor regression after preoperative chemoradiotherapy for rectal cancer. J Clin Oncol. 2005;23:8688-96.
48. Crane CH, Skibber JM, Feig BW, et al. Response to preoperative chemoradiation increases the use of sphincter-preserving surgery in patients with locally advanced low rectal carcinoma. Cancer. 2003;97:517-24.
49. Aschele C, Friso ML, Pucciarelli S, et al. A phase I-II study of weekly oxaliplatin, 5-fluorouracil continuous infusion and preoperative radiotherapy in locally advanced rectal cancer. Ann Oncol. 2005;16:1140-6.
50. Carlomagno C, Farella A, Bucci L, et al. Neo-adjuvant treatment of rectal cancer with capecitabine and oxaliplatin in combination with radiotherapy: a phase II study. Ann Oncol. 2009;20:906-12.
51. Das P, Skibber J, Rodriguez-Bigas M, et al. Predictors of tumor response and downstaging in patients who receive preoperative chemoradiation for rectal cancer. Cancer. 2007;109:1750-5.
52. Pucciarelli S, Capirci C, Emanuele U, et al. Relationship between pathologic T-stage and nodal metastasis after preoperative chemoradiotherapy for locally advanced rectal cancer. Ann Surg Oncol. 2005;12:111-6.
53. Rengan R, Paty PB, Wong WD, et al. Ten-year results of preoperative radiation followed by sphincter preservation for rectal cancer: increased local failure rate in nonresponders. Clin Colorectal Cancer. 2006;5:413-21.
54. Rödel C, Liersch T, Hermann RM, et al. Multicenter phase II trial of chemoradiation with oxaliplatin for rectal cancer. J Clin Oncol. 2007;25:110-7.
55. Rosenthal DI, Catalano PJ, Haller DG, et al. Phase I study of preoperative radiation therapy with concurrent infusional 5-fluorouracil and oxaliplatin followed by surgery and postoperative 5-fluorouracil plus leucovorin for T3/T4 rectal adenocarcinoma: ECOG E1297. Int J Radiat Oncol Biol Phys. 2008;72:108-13.
56. Roh MS, Colangelo LH, O'Connell MJ, et al. Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol. 2009;27:5124-30.
57. Stipa F, Chessin D, Shia J, et al. A pathologic complete response of rectal cancer to preoperative combined-modality therapy results in improved oncological outcome compared with those who achieve no downstaging on the basis of preoperative endorectal ultrasonography. Ann Surg Oncol. 2006;13:1047-53.
58. Capirci C, Valentini V, Cionini L, et al. Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: long-term analysis of 566 ypCR patients. Int J Radiat Oncol Biol Phys. 2008;72:99-107.
59. Suárez J, Vera R, Balén E, et al. Pathologic response assessed by Mandard grade is a better prognostic factor than down staging for disease-free survival after preoperative radiochemotherapy for advanced rectal cancer. Colorectal Dis. 2008;10:563-8.
60. Janjan NA, Khoo VS, Abbruzzese J, et al. Tumor downstaging and sphincter preservation with preoperative chemoradiation in locally advanced rectal cancer: the M. D. Anderson Cancer Center experience. Int J Radiat Oncol Biol Phys. 1999;44:1027-38.
61. Willett C, Duda D, Tomaso E, et al. Complete pathological response to bevacizumab and chemoradiation in advanced rectal cancer. Nat Clin Pract Oncol. 2007;4:316-21.
62. Kuremsky JG, Tepper JE, McLeod HL. Biomarkers for response to neoadjuvant chemoradiation for rectal cancer. Int J Radiat Oncol Biol Phys. 2009;74:673-88.
63. Glynne-Jones R, Mawdsley S, Pearce T, Buyse M. Alternative clinical end points in rectal cancer-are we getting closer? Ann Oncol. 2006;17:1239-48.
64. Quirke P, Durdey P, Dixon MF, Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet. 1986;2:996-9.
65. Mohiuddin M, Marks J, Marks G. Management of rectal cancer: short-vs. long-course preoperative radiation. Int J Radiat Oncol Biol Phys. 2008;72:636-43.
66. Beets GL MM, Nelemans PJ, Valentini V, et al. Evaluation of response after chemoradiation for rectal cancer as a predictive factor for the benefit of adjuvant chemotherapy: a pooled analysis of 2724 patients. Presented at: 2011 ASCO Gastrointestinal Cancers Symposium, 20-22 Jan 2011, San Francisco, CA.
67. Kim CJ, Yeatman TJ, Coppola D, et al. Local excision of T2 and T3 rectal cancers after downstaging chemoradiation. Ann Surg. 2001;234:352-8.
68. Coco C, Manno A, Mattana C, et al. The role of local excision in rectal cancer after complete response to neoadjuvant treatment. Surg Oncol. 2007;16(Suppl. 1):S101-4.
69. Bonnen M, Crane C, Vauthey JN, et al. Long-term results using local excision after preoperative chemoradiation among selected T3 rectal cancer patients. Int J Radiat Oncol Biol Phys. 2004;60:1098-105.
70. Read TE, Andujar JE, Caushaj PF, et al. Neoadjuvant therapy for rectal cancer: histologic response of the primary tumor predicts nodal status. Dis Colon Rectum. 2004;47:825-31.
71. Borschitz T, Wachtlin D, Möhler M, Schmidberger H, Junginger T. Neoadjuvant chemoradiation and local excision for T2-3 rectal cancer. Ann Surg Oncol. 2008;15:712-20.
72. Ota DM, Nelson H, ACOSOG Group. Local excision of rectal cancer revisited: ACOSOG protocol Z6041. Ann Surg Oncol. 2007;14:271.