Sheng XQ, Wang HZ, Li S, Zhang YZ, Geng JH, Zhu XG, Quan JZ, Li YH, Cai Y, Wang WH. Consolidation chemotherapy with capecitabine after neoadjuvant chemoradiotherapy in high-risk patients with locally advanced rectal cancer: Propensity score study. World J Gastrointest Oncol 2022; 14(9): 1711-1726 [PMID: 36187388 DOI: 10.4251/wjgo.v14.i9.1711]
Corresponding Author of This Article
Wei-Hu Wang, MD, Chief Physician, Department of Radiation Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Fucheng Road, Beijing 100142, China. wangweihu88@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Gastrointest Oncol. Sep 15, 2022; 14(9): 1711-1726 Published online Sep 15, 2022. doi: 10.4251/wjgo.v14.i9.1711
Table 1 The clinical characteristics between the two groups
CC group (n = 129)
non-CC group (n = 136)
P value
Gender, n (%)
0.177
Male
84 (65.1)
99 (72.8)
Female
45 (34.9)
37 (27.2)
Age, yr
0.446
mean (SD)
57.5 (11.4)
58.5 (9.8)
Primary location, n (%)
0.812
Up
4 (3.1)
6 (4.4)
Middle
60 (46.5)
65 (47.8)
Low
65 (50.4)
65 (47.8)
Pathology, n (%)
0.996
Well differentiated
6 (4.7)
6 (4.4)
Moderately differentiated
95 (73.6)
102 (75.0)
Poorly differentiated
16 (12.4)
16 (11.8)
Others
12 (9.3)
12 (8.8)
CEA, n (%)
0.307
Normal
67 (51.9)
64 (47.1)
Unnormal
49 (38.0)
63 (46.3)
Unidentified
13 (10.1)
9 (6.6)
T stage, n (%)
0.650
< T3c
49 (38.0)
48 (35.3)
> T3b
80 (62.0)
88 (64.7)
N stage, n (%)
0.190
N0
12 (9.3)
7 (5.1)
N+
117 (90.7)
129 (94.9)
Tumor length (mm)
0.916
mean (SD)
49.0 (12.7)
49.1 (13.7)
Tumor thickness (mm)
0.838
mean (SD)
16.4 (5.0)
16.5 (7.2)
MRF, n (%)
0.501
Negative
31 (24.0)
28 (20.6)
Positive
98 (76.0)
108 (79.4)
EMVI, n (%)
0.565
Negative
44 (34.1)
51 (37.5)
Positive
85 (65.9)
85 (62.5)
Numbers of high-risk factor, n (%)
0.557
1
38 (29.5)
34 (25.0)
2
48 (37.2)
59 (43.4)
3
43 (33.3)
43 (31.6)
Interval time (d)
0.040
mean (SD)
71.7 (21.7)
76.8 (18.5)
Table 2 The clinical parameters between the two groups after propensity score match and inverse probability of treatment weighting
PSM
IPTW
non-CC group (n = 105)
CC-group (n = 105)
P value
non-CC group (n = 130)
CC-group (n = 135)
P value
Gender, n (%)
0.762
0.970
Male
75 (71.4)
73 (69.5)
89.4 (68.5)
92.6 (68.7)
Female
30 (28.6)
32 (30.5)
41.1 (31.5)
42.2 (31.3)
Age
0.692
0.993
mean (SD)
57.7 (11.8)
58.3 (9.7)
58.2 (11.2)
58.2 (9.7)
Primary location, n (%)
0.849
0.996
Up
3 (2.9)
2 (1.9)
4.9 (3.8)
4.9 (3.7)
Middle
52 (49.5)
50 (47.6)
61.0 (46.7)
63.8 (47.3)
Low
50 (47.6)
53 (50.5)
64.6 (49.5)
66.1 (49.0)
Pathology, n (%)
0.903
0.999
Well-differentiated
5 (4.8)
5 (4.8)
6.3 (4.9)
6.6 (4.9)
Moderately-differentiated
79 (75.2)
75 (71.4)
94.0 (72.0)
97.9 (72.6)
Poorly-differentiated
12 (11.4)
13 (12.4)
16.6 (12.7)
17.0 (12.6)
Others
9 (8.6)
12 (11.4)
13.6 (10.4)
13.3 (9.9)
CEA, n (%)
0.428
0.997
Normal
51 (48.6)
58 (55.2)
64.1 (49.1)
66.8 (49.5)
Unnormal
45 (42.9)
42 (40.0)
55.2 (42.3)
56.7 (42.1)
unidentified
9 (8.6)
5 (4.8)
11.2 (8.6)
11.3 (8.4)
T stage, n (%)
0.568
0.992
< T3c
41 (39.0)
37 (35.2)
48.0 (36.8)
49.7 (36.9)
> T3b
64 (61.0)
68 (64.8)
82.5 (63.2)
85.1 (63.1)
N stage, n (%)
0.097
0.176
N0
10 (9.5)
4 (3.8)
12.1 (9.3)
6.7 (5.0)
N+
95 (90.5)
101 (96.2)
118.4 (90.7)
128.1 (95.0)
Tumor length (mm)
0.916
0.983
mean (SD)
48.6 (13.0)
48.4 (13.2)
48.9 (12.5)
48.9 (13.5)
Tumor thickness (mm)
0.484
0.999
mean (SD)
16.6 (5.0)
16.0 (7.0)
16.4 (4.9)
16.4 (7.2)
MRF, n (%)
> 0.99
0.865
Negative
23 (21.9)
23 (21.9)
29.7 (22.8)
29.5 (21.9)
Positive
82 (78.1)
82 (78.1)
100.7 (77.2)
105.3 (78.1)
EMVI, n (%)
0.771
0.998
Negative
35 (33.3)
37 (35.2)
46.4 (35.6)
48.0 (35.6)
Positive
70 (66.7)
68 (64.8)
84.0 (64.4)
86.8 (64.4)
Numbers of high-risk factor, n (%)
0.510
0.883
1
31 (29.5)
26 (24.8)
36.5 (28.0)
35.1 (26.0)
2
37 (35.2)
45 (42.9)
51.2 (39.2)
56.9 (42.2)
3
37 (35.2)
34 (32.4)
42.8 (32.8)
42.8 (31.7)
Interval time (d)
0.659
0.819
mean (SD)
74.4 (20.0)
75.6 (18.4)
75.5 (25.1)
74.8 (17.7)
Table 3 Details of surgical and pathological results in the original samples before matching and after propensity score match in the two groups
Original samples
PSM
non-CC group (n = 124)
CC group (n = 126)
P value
non-CC group (n = 100)
CC group (n = 96)
P value
Interval time (d)
0.015
0.410
mean (SD)
71.7 (21.9)
77.9 (18.6)
74.5 (20.1)
76.8 (18.7)
Surgical method, n (%)
0.232
0.990
APR
42 (33.9)
31 (24.6)
30 (30.0)
29 (30.2)
LAR
77 (62.1)
91 (72.2)
66 (66.0)
63 (65.6)
Hartmann
5 (4.0)
4 (3.2)
4 (4.0)
4 (4.2)
Surgery time (h)
0.684
0.953
mean (SD)
3.0 (1.3)
3.1 (1.4)
3.0 (1.3)
3.0 (1.4)
Blood loss (mL)
0.345
0.407
mean (SD)
75.4 (51.4)
105.4 (145.5)
74.5 (47.8)
99.3 (105.0)
R0, n (%)
123 (99.2)
124 (98.4)
0.571
99 (99.0)
94 (97.9)
0.537
Numbers of dissected lymph nodes
0.194
0.502
mean (SD)
9.1 (4.9)
8.3 (5.0)
9 (4.8)
8.54 (5.0)
pT satge, n (%)
0.400
0.136
T0
21 (16.9)
31 (24.6)
17 (17.0)
28 (29.2)
T1
6 (4.8)
10 (7.0)
5 (5.0)
9 (9.4)
T2
41 (33.1)
34 (27.0)
32 (32.0)
28 (29.2)
T3
54 (43.5)
50 (39.7)
44 (44.0)
30 (31.2)
T4
2 (1.6)
1 (0.8)
2 (2.0)
1 (1.0)
pN stage, n (%)
0.541
0.712
N0
90 (72.6)
99 (78.6)
72 (72.0)
74 (77.1)
N1
26 (21.0)
21 (16.7)
22 (22.0)
17 (17.7)
N2
8 (6.5)
6 (4.8)
6 (6.0)
5 (5.2)
TRG, n (%)
0.123
0.015
0
21 (16.9)
31 (24.6)
17 (17.0)
28 (29.1)
1
43 (34.7)
51 (40.5)
33 (33.0)
41 (42.7)
2
59 (47.6)
42 (33.3)
49 (49.0)
26 (27.1)
0.176
3
1 (0.8)
2 (1.6)
1 (1.0)
1 (1.1)
pT0-2N0, n (%)
57 (46.0)
66 (52.4)
0.311
46 (46.0)
57 (59.4)
0.061
pCR, n (%)
18 (14.5)
27 (21.4)
0.155
14 (14.0)
24 (25.0)
0.051
Table 4 The complete response rate and univariate regression of consolidation chemotherapy in the original samples before matching, after propensity score match and inverse probability of treatment weighting in the two groups
CR
Univariate regression
non-CC group, n (%)
CC group, n (%)
P value
OR (95%CI)
P value
Original samples
21 (16.3)
33 (24.3)
0.107
1.648 (0.895-3.033)
0.109
PSM
17 (16.2)
29 (27.6)
0.045
1.975 (1.008-3.871)
0.047
IPTW
21 (16.3)
35 (25.9)
0.045
1.185 (1.008-3.395)
0.047
Table 5 Toxicities during neoadjuvant treatment in the two groups
non-CC group (n = 129), n (%)
CC group (n = 136), n (%)
Grade 1
Grade 2
Grade 3
Grade 4-5
Grade 1
Grade 2
Grade 3
Grade 4-5
Total
59 (45.7)
64 (49.6)
5 (3.9)
0
66 (48.5)
63 (46.3)
4 (2.9)
0
Leukopenia
47 (36.4)
29 (22.5)
2 (1.6)
0
51 (37.5)
27 (19.9)
0
0
Neutropenia
22 (17.1)
9 (7.0)
0
0
22 (16.2)
9 (6.6)
0
0
Anemia
5 (3.9)
6 (4.7)
2 (1.6)
0
14 (10.3)
5 (3.7)
0
0
Thrombocytopenia
9 (7.0)
0
1 (0.8)
0
5 (3.7)
0
0
0
Aminotransferase increased
0 (0.0)
1 (0.8)
0
0
6 (4.4)
0
0
0
Bilirubin increased
19 (14.7)
2 (3.1)
0
0
18 (13.2)
2 (1.5)
1 (0.7)
0
Nausea
39 (30.2)
0
0
0
30 (22.1)
1 (0.7)
0
0
Fatigue
58 (45.0)
3 (2.3)
0
0
66 (44.9)
2 (1.5)
0
0
Proctitis/diarrhea
66 (51.2)
36 (27.9)
1 (0.8)
0
66 (48.5)
39 (28.7)
2 (1.5)
0
Cystitis
38 (29.5)
0
0
0
42 (30.9)
0
0
0
Radiodermatitis
75 (58.1)
6 (4.7)
0
0
70 (51.5)
3 (2.2)
0
0
Citation: Sheng XQ, Wang HZ, Li S, Zhang YZ, Geng JH, Zhu XG, Quan JZ, Li YH, Cai Y, Wang WH. Consolidation chemotherapy with capecitabine after neoadjuvant chemoradiotherapy in high-risk patients with locally advanced rectal cancer: Propensity score study. World J Gastrointest Oncol 2022; 14(9): 1711-1726