ArticleCancer cell international2019
Adjuvant chemotherapy for rectal cancer with complete pathological response (pCR) may not be necessary: a pooled analysis of 5491 patients.
Article in Cancer cell international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0.Annals of coloproctology · 2026Guideline
- Impact of adjuvant chemotherapy on survival after pathological complete response in rectal cancer: a meta-analysis of 31,558 patients.International journal of colorectal disease · 2024Pooled it
- Effect of adjuvant chemotherapy on the oncological outcome of rectal cancer patients with pathological complete response.World journal of surgical oncology · 2024Pooled it
- Current evidence regarding the role of adjuvant chemotherapy in rectal cancer patients with pathologic complete response after neoadjuvant chemoradiotherapy: a systematic review and meta-analysis.International journal of colorectal disease · 2021Pooled it
- Clinical characteristics and survival outcomes of well-responders following definite comprehensive treatment in locally advanced rectal cancer.BMC cancer · 2025Article
- Review
- Clinical significance of adjuvant chemotherapy for pathological complete response rectal cancer patients with acellular mucin pools after neoadjuvant chemoradiotherapy.Therapeutic advances in gastroenterology · 2023Article
- Predicting the risk of distant metastasis in patients with locally advanced rectal cancer using model based on pre-treatment T2WI-based radiomic features plus postoperative pathological stage.Frontiers in oncology · 2023Article
- miRNA-148a Enhances the Treatment Response of Patients with Rectal Cancer to Chemoradiation and Promotes Apoptosis by Directly TargetingBiomedicines · 2021Article
- Article
- MRI-defined high-risk rectal cancer patients: outcome comparison between neoadjuvant chemoradiotherapy plus TME and TME plus adjuvant chemotherapy or TME alone.The British journal of radiology · 2021Article
- Nomogram to Predict Distant Metastasis Probability for Pathological Complete Response Rectal Cancer Patients After Neoadjuvant Chemoradiotherapy.Cancer management and research · 2021Article
- Review
- Rectal cancer patients with downstaging after neoadjuvant chemoradiotherapy and radical resection do not benefit from adjuvant chemotherapy.Annals of translational medicine · 2020Article
- Pretreatment MRI Parameters and Neutrophil-to-Lymphocyte Ratio Could Predict the Long-Term Prognosis of Locally Advanced Rectal Cancer Patients With Pathological Complete Response after Neoadjuvant Chemoradiotherapy.Cancer control : journal of the Moffitt Cancer CenterArticle
- Prognostic Significance of Neoadjuvant Rectal Score and Indication for Postoperative Adjuvant Therapy in Rectal Cancer Patients After Neoadjuvant Chemoradiotherapy.In vivo (Athens, Greece)Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is recommended postoperative adjuvant chemotherapy for all rectal cancers undergoing neo-chemoradiotherapy regardless of the final yield pathology. However, the role of adjuvant chemotherapy in pathological complete response (pCR) remains controversial. We aimed to identify the necessarily of adjuvant chemotherapy in pCR.
methodsConsecutive patients with pCR in Fudan University Shanghai Cancer Center (FUSCC) were enrolled. Meanwhile, a pooled analysis of individual patient with pCR was performed from PubMed and Embase databases for validation.
resultsA total of 171 patients form FUSCC were identified to achieve pCR with up to almost 10 years follow-up. Among them, those receiving adjuvant chemotherapy had no survival benefits compared to those without adjuvant chemotherapy (log-rank test = 0.17, P = 0.676). The 5y-DFS rates for patients in chemo group and no-chemo group was 87.5 and 88.8%, respectively, showing no significant difference (p = 0.854). No matter chemotherapy regimens, T stage, EMVI and CRM status varied, the results remained consistent. Meantime, the COX model did not demonstrate adjuvant chemotherapy as the independent risk factor for OS and DFS. Additionally, among 18 systemic recurrences in all, the rate of relapse surged rapidly on the 12 months and rose up to peak in the 36th months. In order to validate these results, nine controlled trials involving 5491 patients with pCR were included in this pooled-analysis. For both 5-year overall survival and disease-free survival, the pooling data did not produce a statistically significant effect in cases of adjuvant chemotherapy performed (RR = 0.79 and RR = 0.95, respectively, all p > 0.05).
conclusionThis study suggested that rectal cancer patients with pCR did not benefit from adjuvant chemotherapy and we recommended that achievement of pCR require more prolonged close follow care in case of distant metastasis.
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