PMID- 30368569
OWN - NLM
STAT- MEDLINE
DCOM- 20190415
LR  - 20190415
IS  - 1432-1262 (Electronic)
IS  - 0179-1958 (Linking)
VI  - 34
IP  - 1
DP  - 2019 Jan
TI  - Is adjuvant chemotherapy necessary for locally advanced rectal cancer patients
      with pathological complete response after neoadjuvant chemoradiotherapy and
      radical surgery? A systematic review and meta-analysis.
PG  - 113-121
LID - 10.1007/s00384-018-3181-9 [doi]
AB  - PURPOSE: Current clinical guidelines recommended the routine use of adjuvant
      chemotherapy for locally advanced rectal cancer (LARC) patients. However, the
      effects of adjuvant chemotherapy in patients with pathological complete response 
      (pCR) after neoadjuvant chemoradiotherapy and radical surgery showed
      discrepancies in different investigations. METHODS: A systematic review and
      meta-analysis were conducted using PubMed, Embase and Web of Science databases.
      All original comparative studies published in English that were related to
      adjuvant versus non-adjuvant chemotherapy for LARC patients with pCR were
      included. RESULTS: A total of 6 studies based on 18 centres or databases
      involving 2948 rectal cancer patients with pCR (adjuvant group = 1324,
      non-adjuvant group = 1624) were included in our overall analysis. Based on our
      meta-analysis, LARC patients with pCR who received adjuvant chemotherapy showed a
      significantly improved overall survival (OS) when compared to patients with
      observation (HR = 0.65, 95% CI = 0.46-0.90, P = 0.01). In addition,
      investigations focused on this issue based on the National Cancer Database (NCDB)
      were systematically reviewed in our current study. Evidence from all three
      analyses demonstrated that LARC patients with clinical nodal positive disease
      that achieved pCR might benefit the most from additional adjuvant chemotherapy.
      CONCLUSION: Our meta-analysis indicated that adjuvant chemotherapy is associated 
      with improved OS in LARC patients with pCR after neoadjuvant chemoradiotherapy
      and radical surgery.
FAU - Ma, Bin
AU  - Ma B
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Ren, Yupeng
AU  - Ren Y
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Chen, Yue
AU  - Chen Y
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Lian, Bo
AU  - Lian B
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Jiang, Peng
AU  - Jiang P
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Li, Yongmin
AU  - Li Y
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Shang, Yan
AU  - Shang Y
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
FAU - Meng, Qingkai
AU  - Meng Q
AUID- ORCID: http://orcid.org/0000-0001-7098-4592
AD  - Department of Colorectal Surgery, Cancer Hospital of China Medical University,
      Liaoning Cancer Hospital and Institute, No. 44 Xiaoheyan Road, Dadong District,
      Shenyang, 110042, Liaoning Province, People's Republic of China.
      mqk1971colorectal@163.com.
LA  - eng
GR  - 20180550485/Natural Science Foundation of Liaoning Province
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20181027
PL  - Germany
TA  - Int J Colorectal Dis
JT  - International journal of colorectal disease
JID - 8607899
SB  - IM
MH  - *Chemoradiotherapy
MH  - Chemotherapy, Adjuvant
MH  - Humans
MH  - Neoplasm Staging
MH  - Rectal Neoplasms/*pathology/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adjuvant chemotherapy
OT  - Locally advanced rectal cancer
OT  - Meta-analysis
OT  - Pathological complete response
EDAT- 2018/10/29 06:00
MHDA- 2019/04/16 06:00
CRDT- 2018/10/29 06:00
PHST- 2018/10/19 00:00 [accepted]
PHST- 2018/10/29 06:00 [pubmed]
PHST- 2019/04/16 06:00 [medline]
PHST- 2018/10/29 06:00 [entrez]
AID - 10.1007/s00384-018-3181-9 [doi]
AID - 10.1007/s00384-018-3181-9 [pii]
PST - ppublish
SO  - Int J Colorectal Dis. 2019 Jan;34(1):113-121. doi: 10.1007/s00384-018-3181-9.
      Epub 2018 Oct 27.