Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer
ABSTRACT Purpose To compare the long‐term survival of patients with locally advanced low rectal cancer (LALRC), receiving neoadjuvant chemoradiotherapy (NCRT) versus adjuvant chemoradiotherapy (ACRT). Methods and Materials This retrospective observational study included 1169 patients with LALRC (Sta...
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| Format: | Article |
| Language: | English |
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Wiley
2025-08-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.71042 |
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| author | Siyuan Chen Ruiyan Wu Juefeng Wan Yun Xu Yaqi Wang Zhiyuan Zhang Lili Huang Yujun Liu Yingxuan Lin Luoxi He Yun Deng Fan Xia Ye Xu Zhen Zhang Hongtu Zheng |
| author_facet | Siyuan Chen Ruiyan Wu Juefeng Wan Yun Xu Yaqi Wang Zhiyuan Zhang Lili Huang Yujun Liu Yingxuan Lin Luoxi He Yun Deng Fan Xia Ye Xu Zhen Zhang Hongtu Zheng |
| author_sort | Siyuan Chen |
| collection | DOAJ |
| description | ABSTRACT Purpose To compare the long‐term survival of patients with locally advanced low rectal cancer (LALRC), receiving neoadjuvant chemoradiotherapy (NCRT) versus adjuvant chemoradiotherapy (ACRT). Methods and Materials This retrospective observational study included 1169 patients with LALRC (Stage II/III disease located ≤ 5 cm from the anal verge) who underwent diagnosis and treatment at Fudan University Shanghai Cancer Center from February 2006 to March 2021. In Stage II/III low rectal cancer patients, one‐to‐one matched pairs were created from the ACRT and NCRT groups using propensity score matching (PSM) based on baseline characteristics. OS and DFS were evaluated using the Kaplan–Meier method alongside the univariate Cox regression model. Results In Stage II patients, 65 received ACRT and 107 received NCRT. For Stage III, 282 received ACRT and 715 received NCRT. After PSM, 45 paired Stage II patients and 243 paired Stage III patients were selected. In Stage II patients, there was no significant difference in OS and DFS between the groups. For Stage III, the 5‐ and 10‐year OS rates were 79.61% and 77.67% in the NCRT group, compared to 61.08% and 44.57% in the ACRT group (p < 0.001). The 5‐ and 10‐year DFS rates were 69.93% and 65.26% in the NCRT group, versus 48.07% and 40.77% in the ACRT group (p < 0.001). Additionally, in Stage III patients, NCRT was associated with a significant reduction in the risk of death and recurrence compared to ACRT (OS: HR = 0.47, p = 0.0001; DFS: HR = 0.55, p = 0.0001). Conclusion For patients with Stage III low rectal cancer, NCRT significantly improved the long‐term DFS rate and OS rate, in comparison to adjuvant chemoradiotherapy. |
| format | Article |
| id | doaj-art-c96b4c171ef248ed9d1abb53f384e4b4 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-c96b4c171ef248ed9d1abb53f384e4b42025-08-20T04:03:08ZengWileyCancer Medicine2045-76342025-08-011415n/an/a10.1002/cam4.71042Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal CancerSiyuan Chen0Ruiyan Wu1Juefeng Wan2Yun Xu3Yaqi Wang4Zhiyuan Zhang5Lili Huang6Yujun Liu7Yingxuan Lin8Luoxi He9Yun Deng10Fan Xia11Ye Xu12Zhen Zhang13Hongtu Zheng14Department of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Oncology Shanghai Medical College, Fudan University Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Oncology Shanghai Medical College, Fudan University Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Oncology Shanghai Medical College, Fudan University Shanghai ChinaABSTRACT Purpose To compare the long‐term survival of patients with locally advanced low rectal cancer (LALRC), receiving neoadjuvant chemoradiotherapy (NCRT) versus adjuvant chemoradiotherapy (ACRT). Methods and Materials This retrospective observational study included 1169 patients with LALRC (Stage II/III disease located ≤ 5 cm from the anal verge) who underwent diagnosis and treatment at Fudan University Shanghai Cancer Center from February 2006 to March 2021. In Stage II/III low rectal cancer patients, one‐to‐one matched pairs were created from the ACRT and NCRT groups using propensity score matching (PSM) based on baseline characteristics. OS and DFS were evaluated using the Kaplan–Meier method alongside the univariate Cox regression model. Results In Stage II patients, 65 received ACRT and 107 received NCRT. For Stage III, 282 received ACRT and 715 received NCRT. After PSM, 45 paired Stage II patients and 243 paired Stage III patients were selected. In Stage II patients, there was no significant difference in OS and DFS between the groups. For Stage III, the 5‐ and 10‐year OS rates were 79.61% and 77.67% in the NCRT group, compared to 61.08% and 44.57% in the ACRT group (p < 0.001). The 5‐ and 10‐year DFS rates were 69.93% and 65.26% in the NCRT group, versus 48.07% and 40.77% in the ACRT group (p < 0.001). Additionally, in Stage III patients, NCRT was associated with a significant reduction in the risk of death and recurrence compared to ACRT (OS: HR = 0.47, p = 0.0001; DFS: HR = 0.55, p = 0.0001). Conclusion For patients with Stage III low rectal cancer, NCRT significantly improved the long‐term DFS rate and OS rate, in comparison to adjuvant chemoradiotherapy.https://doi.org/10.1002/cam4.71042adjuvant chemoradiotherapylocally advanced low rectal cancerneoadjuvant chemoradiotherapyoncologic outcomeoverall survival |
| spellingShingle | Siyuan Chen Ruiyan Wu Juefeng Wan Yun Xu Yaqi Wang Zhiyuan Zhang Lili Huang Yujun Liu Yingxuan Lin Luoxi He Yun Deng Fan Xia Ye Xu Zhen Zhang Hongtu Zheng Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer Cancer Medicine adjuvant chemoradiotherapy locally advanced low rectal cancer neoadjuvant chemoradiotherapy oncologic outcome overall survival |
| title | Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer |
| title_full | Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer |
| title_fullStr | Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer |
| title_full_unstemmed | Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer |
| title_short | Long‐Term Survival Analysis of Neoadjuvant Chemoradiotherapy Versus Adjuvant Chemoradiotherapy for Locally Advanced Low Rectal Cancer |
| title_sort | long term survival analysis of neoadjuvant chemoradiotherapy versus adjuvant chemoradiotherapy for locally advanced low rectal cancer |
| topic | adjuvant chemoradiotherapy locally advanced low rectal cancer neoadjuvant chemoradiotherapy oncologic outcome overall survival |
| url | https://doi.org/10.1002/cam4.71042 |
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