Survival landscape of different tumor regression grades and pathologic complete response in rectal cancer after neoadjuvant therapy based on reconstructed individual patient data

BMC Cancer

Jia-yi Li¹  Qiong Xiao¹  Xing-er Lv¹  Yv Fu¹  Peng Gao¹  Xuan-zhang Huang¹  Xiao-wan Chen¹  Shi-yv Ye¹  Yong-xi Song¹  Zhen-ning Wang¹ 

[1] Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, 110001, Shenyang City, China;

关键词: Rectal cancer;    Neoadjuvant therapy;    Pathological complete response;    Tumor regression grade;    Survival;   

DOI  :  10.1186/s12885-021-08922-1

来源: Springer

【 摘 要 】

BackgroundNeoadjuvant therapy can lead to different tumor regression grades (TRG) in rectal cancer after neoadjuvant therapy. The purposes of this study are to investigate the relationships among TRG, pathologic complete response (pCR) and long-term survival, on the basis of reconstructed individual patient data (IPD).MethodsThe PubMed, Embase, Ovid and Cochrane CENTRAL databases were searched. The primary endpoint was to evaluate the survival landscape of different TRGs after neoadjuvant therapy and the secondary endpoint was to evaluate the associations between pCR and survival. IPD were reconstructed with Kaplan–Meier curves.ResultsThe 10-year overall survival (OS) and 5-year disease-free survival (DFS) were clearly higher in the pCR group than in the non-pCR (npCR) group (80.5% vs. 48.3, 90.1% vs. 69.8%). Furthermore, the OS and DFS increased with improvement in tumor regression after neoadjuvant therapy. According to the IPD, the pCR group had longer OS (HR = 0.240, 95% CI = 0.177–0.325, p < 0.001) and DFS (HR = 0.274, 95% CI = 0.205–0.367, p < 0.001) than the npCR group. Better tumor regression was associated with better survival outcomes (p < 0.005). Direct calculation of published HR values yielded similar results.ConclusionsOur results indicate a positive relationship between better tumor regressions and improved survival benefits among the npCR group and patients with rectal cancer achieving pCR had much longer OS and DFS than patients achieving npCR, presenting a survival landscape of different TRGs and pCR in rectal cancer after neoadjuvant therapy.

【 授权许可】

CC BY