Li WC, Zhao JK, Feng WQ, Miao YM, Xu ZF, Xu ZQ, Gao H, Sun J, Zheng MH, Zong YP, Lu AG. Retrospective research of neoadjuvant therapy on tumor-downstaging, post-operative complications, and prognosis in locally advanced rectal cancer. World J Gastrointest Surg 2021; 13(3): 267-278 [PMID: 33796215 DOI: 10.4240/wjgs.v13.i3.267]
Corresponding Author of This Article
Ai-Guo Lu, MD, PhD, Chief Doctor, Professor, Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197 Ruijin 2nd Road, Shanghai 200025, China. luaiguo1965@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective 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/
Wen-Chang Li, Jing-Kun Zhao, Wen-Qing Feng, Yi-Ming Miao, Zi-Feng Xu, Zhuo-Qing Xu, Han Gao, Jing Sun, Min-Hua Zheng, Ya-Ping Zong, Ai-Guo Lu, Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
Author contributions: Li WC and Zhao JK contributed equally to this study; Li WC, Zhao JK, Zong YP, and Lu AG designed the research; Feng WQ, Miao YM, and Xu ZF collected the data and prepared the manuscript; Li WC, Zhao JK, Xu ZQ, and Gao H analyzed the data and wrote the manuscript; Sun J and Zheng MH helped design the study with constructive discussions; All authors have read and approved the final manuscript.
Supported byNational Science Foundation of China, No. 81871933; and National Science Foundation of China for Youth, No. 81802326.
Institutional review board statement: The study was reviewed and approved by the Shanghai Ruijin Hospital Ethics Committee (Approval No. 2016-072).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
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: Ai-Guo Lu, MD, PhD, Chief Doctor, Professor, Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197 Ruijin 2nd Road, Shanghai 200025, China. luaiguo1965@163.com
Received: October 9, 2020 Peer-review started: October 9, 2020 First decision: December 8, 2020 Revised: December 13, 2020 Accepted: January 15, 2021 Article in press: January 15, 2021 Published online: March 27, 2021 Processing time: 157 Days and 19.9 Hours
ARTICLE HIGHLIGHTS
Research background
Neoadjuvant therapy (NAT) is becoming the standard way to treat locally advanced rectal cancer (LARC). Radiation has been an important part of NAT. More research on preoperative radiation is warranted.
Research motivation
To explore what kind of impact preoperative radiation has on tumor downstaging, postoperative complications, and survival in LARC. To provide more evidence for choosing a NAT regimen.
Research objectives
To compare the downstaging effect, postoperative complications, and prognosis between two different NAT regimens: The combination of radiation and chemotherapy and chemotherapy alone.
Research methods
We retrospectively collected and analyzed the data of the two different regimens of NAT. The χ2 test was used to compare the downstaging effect, postoperative complications, etc. Kaplan-Meier analysis was used to describe and compare survival.
Research results
The study found that the primary tumor regression effect was better with the combination of radiation and chemotherapy than chemotherapy alone. This agrees with many previous articles. There were no significant differences in postoperative complications between the two groups, while overall survival was better in the radiochemotherapy group. However, no article comparing survival in LARC with or without radiation before surgery has been carried out. This waits to be confirmed by further studies.
Research conclusions
This study tried to compare two different NAT regimens in LARC. Preoperative radiation may contribute to radical surgery in LARC and improve the prognosis as well.
Research perspectives
A prospective study comparing postoperative complications and survival in NAT with or without preoperative radiation waits to be carried out.
