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Pathologic response grade after long-course neoadjuvant chemoradiation does not influence morbidity in locally advanced mid-low rectal cancer resected by laparoscopy

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Patients with locally advanced rectal cancer and pathologic complete response to neoadjuvant chemoradiation therapy have lower rates of recurrence compared to those who do not. However, the influences of the pathologic response on surgical complications and survival remain unclear. This study aimed to investigate the influence of neoadjuvant therapy for rectal cancer on postoperative morbidity and long-term survival.

Methods

This was a comparative study of consecutive patients who underwent laparoscopic total mesorectal excision for rectal cancer in two European tertiary hospitals between 2004 and 2014. Patients with and without pathologic complete responses were compared in terms of postoperative morbidity, mortality, and survival.

Results

Fifty patients with complete response (ypT0N0) were compared with 141 patients who exhibited non-complete response. No group differences were observed in the postoperative mortality or morbidity rates. The median follow-up time was 57 months (range 1–121). Over this period, 11 (5.8 %) patients, all of whom were in the non-complete response group, exhibited local recurrence. The 5-year overall survival and disease-free survival were significantly better in the complete response group, 92.5 vs. 75.3 % (p = 0.004) and 89 vs. 73.4 % (p = 0.002), respectively.

Conclusions

Postoperative complication rate after laparoscopic total mesorectal excision is not associated with the pathologic response grade to neoadjuvant chemoradiation therapy.

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Author information

Authors and Affiliations

  1. Department of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, Université Paris Est, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Creteil, France

    Filippo Landi, Aleix Martinez, Francesco Brunetti, Daniel Azoulay & Nicola de’Angelis

  2. Unit of Colorectal Surgery, Department of General and Digestive Surgery, Vall d’Hebron University Hospital, Barcelona, Spain

    Filippo Landi, Eloy Espín, Victor Rodrigues & Francesc Vallribera

  3. Universidad Autonoma de Barcelona UAB, Barcelona, Spain

    Filippo Landi, Eloy Espín, Victor Rodrigues & Francesc Vallribera

  4. Department of Pathology. Henri Mondor Hospital, AP-HP, Université Paris Est, UPEC, Creteil, France

    Cecile Charpy

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  1. Filippo Landi
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Corresponding author

Correspondence to Filippo Landi.

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Authorship and contributions

Filippo Landi, MD, PhD: experimental conception and design, acquisition, analysis, and interpretation of the data and writing of the manuscript.

Eloy Espín, MD, PhD: experimental conception and design, acquisition and interpretation of the data, critical revision for important intellectual content, and approval of the final draft.

Victor Rodrigues, MD: acquisition and interpretation of the data, critical revision for important intellectual content, and approval of the final draft.

Francesc Vallribera, MD, PhD: acquisition and interpretation of the data, critical revision for important intellectual content, and approval of the final draft.

Aleix Martinez, MD: acquisition and interpretation of the data and approval of the final draft.

Cecile Charpy, MD: acquisition and interpretation of the data, critical revision for important intellectual content, and approval of the final draft.

Francesco Brunetti, MD: experimental conception and design, acquisition and interpretation of the data, critical revision for important intellectual content, and approval of the final draft.

Daniel Azoulay, MD, PhD: interpretation of the data, critical revision for important intellectual content, and approval of the final draft.

Nicola de’Angelis, MD, PhD: experimental conception and design, acquisition and interpretation of data, data analysis, critical revision for important intellectual content, writing of the manuscript, and approval of the final draft.

Conflict of interest

The authors declare that they have no conflict of interest or financial ties to disclose.

Meeting presentation

This study was reported as an oral presentation at the 24th International Congress of the European Society of Endoscopic Surgeons (EAES), celebrated on 15–18th June 2016 in Amsterdam, the Netherlands.

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Landi, F., Espín, E., Rodrigues, V. et al. Pathologic response grade after long-course neoadjuvant chemoradiation does not influence morbidity in locally advanced mid-low rectal cancer resected by laparoscopy. Int J Colorectal Dis 32, 255–264 (2017). https://doi.org/10.1007/s00384-016-2685-4

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