Ebata Yuho, Nakanishi Ryota, Tanaka Yasushi, Kawazoe Tetsuro, Tajiri Hirotada, Zaitsu Yoko, Nakashima Yuichiro, Ota Mitsuhiko, Oki Eiji, Yoshizumi Tomoharu
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Anticancer Res. 2024 Mar;44(3):1281-1287. doi: 10.21873/anticanres.16923.
BACKGROUND/AIM: The efficacy of neoadjuvant chemotherapy (NAC) for colon cancer remains unestablished. This study aimed to investigate the outcomes of NAC in patients with locally advanced T4b or obstructive T4a colon cancers (LACC).
Data of patients with LACC who underwent colon surgery between 2010 and 2022 after NAC at our institution were retrospectively reviewed. Patient characteristics, surgical outcomes, tumor features, and prognosis were analyzed.
Among 800 patients with LACC who underwent radical resection, 11 received NAC because of cT4b or cT4a with mechanical obstruction. NAC, administered as a doublet regimen, had a median duration of three months, without grade ≥3 adverse events. R0 resection was achieved in all patients and downstaging was observed in eight patients. One patient developed a postoperative abdominal abscess, and adjuvant chemotherapy was administered to eight patients. Four patients experienced recurrence: liver metastasis in two, and local recurrence in two. Among these, three patients underwent resection of recurrent tumors. Median follow-up was 30 months.
NAC is feasible for T4b or obstructive T4a colon cancer and may be a treatment option for LACC. Further large-scale studies are required to confirm the efficacy of NAC in these patients.
背景/目的：新辅助化疗（NAC）对结肠癌的疗效尚未确定。本研究旨在调查NAC在局部晚期T4b或梗阻性T4a结肠癌（LACC）患者中的治疗结果。
回顾性分析2010年至2022年期间在我院接受NAC治疗后行结肠手术的LACC患者的数据。分析患者特征、手术结果、肿瘤特征和预后。
在800例行根治性切除的LACC患者中，11例因cT4b或伴有机械性梗阻的cT4a接受了NAC治疗。NAC采用双药方案，中位疗程为3个月，无≥3级不良事件。所有患者均实现了R0切除，8例患者观察到降期。1例患者发生术后腹腔脓肿，8例患者接受了辅助化疗。4例患者出现复发：2例肝转移，2例局部复发。其中，3例患者接受了复发性肿瘤切除术。中位随访时间为30个月。
NAC对T4b或梗阻性T4a结肠癌是可行的，可能是LACC的一种治疗选择。需要进一步的大规模研究来证实NAC在这些患者中的疗效。
