Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2020; 12(12): 1428-1442
Published online Dec 15, 2020. doi: 10.4251/wjgo.v12.i12.1428
Outcomes of neoadjuvant chemoradiotherapy followed by radical resection for T4 colorectal cancer
Chun-Ming Huang, Ching-Wen Huang, Cheng-Jen Ma, Hsiang-Lin Tsai, Wei-Chih Su, Tsung-Kun Chang, Ming-Yii Huang, Jaw Yuan Wang
Chun-Ming Huang, Ming-Yii Huang, Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung 80145, Taiwan
Ching-Wen Huang, Hsiang-Lin Tsai, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80145, Taiwan
Cheng-Jen Ma, Wei-Chih Su, Tsung-Kun Chang, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80145, Taiwan
Jaw Yuan Wang, Department of Surgery and Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Author contributions: Wang JY and Huang MY contributed equally to this paper; Wang JY conceived the concept of the study and supervised the study; Huang CM wrote and drafted the manuscript; Huang CW, Ma CJ, Tsai HL, Su WC, and Chang TK collected and collated the clinical data; Huang MY and Huang CM conducted the statistical analysis and interpreted the results; all authors read and approved the final manuscript.
Supported by the grants through funding from the Ministry of Science and Technology, No. MOST109-2314-B-037-035, No. MOST109-2314-B-037-040, and No. MOST109-2314-B-037-046-MY3; the Ministry of Health and Welfare funded by Health and Welfare Surcharge of Tobacco Products, No. MOHW109-TDU-B-212-124026; the Kaohsiung Medical University Hospital and the Kaohsiung Municipal Ta-Tung Hospital, No. S10903, No. KMUH108-8R34, No. KMUH108-8R35, No. KMUH108-8M33, No. KMUH108-8M35, No. KMUH108-8M36, No. KMUH-DK109003, and No. KMUH-DK109005-3.
Institutional review board statement: This study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-EII-20190281).
Informed consent statement: The informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Data sharing statement: There are no additional data.
STROBE statement: All authors have read the STROBE statement checklist of items. The manuscript was prepared and revised according to the STROBE statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jaw Yuan Wang, MD, PhD, Professor, Department of Surgery and Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tz-You 1st Road, Kaohsiung 80708, Taiwan. cy614112@ms14.hinet.net
Received: August 26, 2020
Peer-review started: August 26, 2020
First decision: October 21, 2020
Revised: November 10, 2020
Accepted: November 17, 2020
Article in press: November 17, 2020
Published online: December 15, 2020
Processing time: 106 Days and 6.3 Hours
Core Tip

Core Tip: Patients with clinical T4 colorectal cancer have a poor prognosis because of compromised surgical margins. This retrospective study demonstrated that neoadjuvant chemoradiotherapy resulted in high rates of pathological complete response and complete resection for patients with T4 colorectal cancer. An aggressive approach that entails implementing the FOLFOX regimen before, during, and after irradiation is safe and can improve pathological complete response rates. Negative resection margins and pathological complete response are significantly associated with survival.