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Neoadjuvant Radiation Therapy in Locally Advanced Colon Cancer: a Cohort Analysis.

Devi Mukkai Krishnamurty1, Alexander T Hawkins1, Katerina O Wells1

  • 1Division of General Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 S. Euclid Avenue, St. Louis, MO, 63110, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|February 11, 2018
PubMed
Summary
This summary is machine-generated.

Neoadjuvant chemoradiation therapy (NRT) for T4 colon cancer is safe and improves T-stage downstaging. While trends suggest better outcomes, NRT did not significantly improve overall survival in multivariable analysis.

Keywords:
AdenocarcinomaLocally advanced colon cancerOutcomesRadiotherapySurgery

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastrointestinal Oncology

Background:

  • Limited data exists on neoadjuvant chemoradiation therapy (NRT) for T4, non-metastatic colon cancer.
  • T4 colon cancer presents a significant challenge due to local invasion.

Purpose of the Study:

  • To evaluate the impact of NRT on oncological outcomes in patients with resected T4 colon cancer.
  • To assess the safety and efficacy of NRT in this specific patient population.

Main Methods:

  • Retrospective cohort study of 131 patients with non-metastatic T4 colon cancer (2000-2012).
  • Patients were divided into NRT and non-NRT groups.
  • Primary outcomes included margin-negative resection (R0) and overall survival (OS).

Main Results:

  • NRT was administered to 17.4% of patients.
  • NRT showed a non-significant trend towards improved R0 resection rates (95.7% vs 88.0%) and reduced local recurrence (4.3% vs 15.7%).
  • A significant increase in T-stage downstaging was observed in the NRT group (30.4% vs 6.5%; p=0.007).
  • Bivariate analysis indicated improved 5-year OS with NRT (76.4% vs 51.5%; p=0.03), but this was not significant in multivariable analysis (HR 2.19; p=0.09).

Conclusions:

  • Neoadjuvant chemoradiation therapy is safe for T4 colon cancer and effectively increases T-stage downstaging.
  • NRT demonstrated a trend towards improved local control and R0 resection rates, though not statistically significant.
  • Overall survival benefit from NRT was not confirmed in multivariable analysis for this cohort.