Outcome of Patients with Locally Advanced Rectal Cancer Pursuing Non-Surgical Strategy in National Cancer Database.
Publication/Presentation Date
6-11-2024
Abstract
BACKGROUND: Survival data on patients with locally advanced rectal cancer (LARC) undergoing non-operative management (NOM) in a real-world setting are lacking.
METHODS: We analyzed LARC patients from the National Cancer Database with the following features: treated between 2010 and 2020, age 18-65 years, Charlson comorbidity index (CCI) ≤ 1, received neoadjuvant multiagent chemotherapy plus radiation ≥ 45 Gray, and underwent surgery or NOM. Patients were stratified into two groups: (A) clinical T1-3 tumors with positive nodes (cT1-3N+) and (B) clinical T4 tumors, N+/- (cT4N+/-). We performed a comparative analysis of overall survival (OS) with NOM versus surgery by the Kaplan-Meier method and propensity score matching. Additionally, a multivariable analysis explored the association between NOM and OS.
RESULTS: NOM exhibited significantly lower OS than surgery in both groups. In cT1-3N+ patients, NOM resulted in a 5-year OS of 73.9% (95% confidence interval [CI] = 69.7-77.6%) versus 84.5% (95% CI = 83.6-85.3%) with surgery (
CONCLUSION: Patients with LARC undergoing NOM versus surgery in real-world settings appear to have inferior survival.
Volume
16
Issue
12
ISSN
2072-6694
Published In/Presented At
Kakish, H., Ahmed, F. A., Ocuin, L. M., Miller-Ocuin, J. L., Steinhagen, E., Hoehn, R. S., Mahipal, A., Towe, C. W., & Chakrabarti, S. (2024). Outcome of Patients with Locally Advanced Rectal Cancer Pursuing Non-Surgical Strategy in National Cancer Database. Cancers, 16(12), 2194. https://doi.org/10.3390/cancers16122194
Disciplines
Medicine and Health Sciences
PubMedID
38927900
Department(s)
Department of Surgery, Lehigh Valley Topper Cancer Institute
Document Type
Article