title: The influence of neoadjuvant therapy for the prognosis in patients with rectal carcinoma: a retrospective study.
abstract: Rectal cancer, defined as a cancerous lesion of the colon distal to the rectosigmoid junction, is the fourth most common cancer cause of death globally. There were 474 patients with rectal cancer who underwent surgery between October 2007 and May 2013 enrolled in our center. Patients were respectively categorized by neoadjuvant therapy. This study aimed to explore the predictive factors that affected the Progression-free survival and overall survival of the patients with rectal cancer. Clinical characteristics of patients were compared with the groups and potential prognostic factors were analyzed by SPSS 19.0. In our study, neoadjuvant therapy increased the anus-retained rate (64.4 vs 53.4 % P = 0.016) and remission rate in the treatment group, compared to the non-treatment group (62.6 vs 34.8 %; P = 0.000). The neoadjuvant concurrent chemoradiotherapy, more operative duration, anus retained and micturition damaged are positive prognostic factors of PFS to patients. Poor differentiation, the tumor of ulcer, invasive, and pT4 stage, contributed the poor factors for PFS of patients (P < 0.05). Additionally, the patients with neoadjuvant concurrent chemoradiotherapy and adjuvant chemotherapy underwent the better prognosis of OS. Adjuvant chemotherapy cannot increase PFS of the patients who accepted neoadjuvant therapy after surgery get pCR, but can improve OS. The anus-retained and neoadjuvant radiotherapy, duration of surgery in rectal cancer have the positive correlation. Micturition damaged and neoadjuvant radiotherapy were positively correlated as well. In conclusion, adjuvant chemotherapy does not improve the PFS of patients with pCR to neoadjuvant therapy, but is good for OS. Further prospective and large population-based clinical studies are needed to establish clinical guidelines for the use of neoadjuvant therapy and adjuvant chemotherapy in patients with rectal cancer.
authors.affiliation: Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.affiliation: Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Rehabilitation Medicine, Center of Bone Metabolism and Repair, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.
authors.forename: Lin-Ang
authors.initials: LA
authors.lastname: Wang
authors.affiliation: Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Wei
authors.affiliation: Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China.
authors.forename: Meng-Xia
authors.initials: MX
authors.lastname: Li
authors.affiliation: Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Qing
authors.affiliation: Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xia
authors.affiliation: Department of Sport Medicine, the First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Cheng
authors.affiliation: Department of Obstetrics and Gynecology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, People's Republic of China.
authors.forename: Dan
authors.initials: D
authors.lastname: Zi
authors.affiliation: Gastrointestinal Surgery, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China. 470820531@qq.com.
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Li
authors.affiliation: Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, No 10 Changjiang Zhi Rd, Yu Zhong District,, Chongqing, 400042, China. dongwang64@sina.com.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies
keywords: Adjuvant chemotherapy; Neoadjuvant therapy; Prognosis; Rectal cancer