Alorabi Mohamed Osama, Gouda Abdelrahman, Abdeen Mohammed, Said Ahmed, Abdelaal Moamen, Eid Reem, Yahia Maha
Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, 11591, Egypt.
Medical Oncology Department, Shefa Al Orman Cancer Hospital, New Tiba City, Egypt.
Int J Colorectal Dis. 2025 Jan 3;40(1):5. doi: 10.1007/s00384-024-04781-x.
The role of adjuvant chemotherapy in rectal cancer patients downstaged to ypT0-2 N0 after neoadjuvant chemoradiotherapy (CRT), and surgery is still debated. This study investigates the impact of adjuvant chemotherapy on survival outcomes in this patient population.
This retrospective study analyzed hospital records of rectal cancer cases from Shefa Al Orman Cancer Hospital between January 2016 and December 2020, focusing on patients downstaged to ypT0-2 N0 after neoadjuvant CRT and surgery. Patients were divided into two groups based on whether they received adjuvant chemotherapy. Baseline characteristics, DFS, and OS were compared, and survival factors were analyzed using univariate and multivariate Cox regression.
Eighty-five patients met the inclusion criteria; 55 received adjuvant chemotherapy, and 30 did not. The median age was 52, but those receiving adjuvant therapy were younger (47 vs. 60 years, P = 0.006). No significant differences were observed in sex, tumor location, or pathology between groups. Although adjuvant chemotherapy showed a trend toward better 3-year DFS (89.5% vs. 81.9%, P = 0.153) and OS (88.1% vs. 84.6%, P = 0.654), these differences were not statistically significant. Univariate and multivariate analyses confirmed no significant effect of adjuvant chemotherapy on DFS or OS, nor were any other variables significantly associated with survival.
Adjuvant chemotherapy did not significantly improve DFS or OS in rectal cancer patients downstaged to ypT0-2 N0 following neoadjuvant CRT and surgery. Further studies are needed to define the role of adjuvant therapy in this group.
新辅助放化疗（CRT）及手术后降期至ypT0-2 N0的直肠癌患者中，辅助化疗的作用仍存在争议。本研究调查辅助化疗对该患者群体生存结局的影响。
这项回顾性研究分析了2016年1月至2020年12月间舍法·奥尔曼癌症医院的直肠癌病例记录，重点关注新辅助CRT及手术后降期至ypT0-2 N0的患者。根据是否接受辅助化疗将患者分为两组。比较基线特征、无病生存期（DFS）和总生存期（OS），并使用单因素和多因素Cox回归分析生存因素。
85例患者符合纳入标准；55例接受辅助化疗，30例未接受。中位年龄为52岁，但接受辅助治疗的患者更年轻（47岁对60岁，P = 0.006）。两组在性别、肿瘤位置或病理方面未观察到显著差异。尽管辅助化疗显示出3年DFS（89.5%对81.9%，P = 0.153）和OS（88.1%对84.6%，P = 0.654）有更好的趋势，但这些差异无统计学意义。单因素和多因素分析证实辅助化疗对DFS或OS无显著影响，其他变量也与生存无显著关联。
新辅助CRT及手术后降期至ypT0-2 N0的直肠癌患者，辅助化疗未显著改善DFS或OS。需要进一步研究来明确辅助治疗在该组患者中的作用。
