抄録
Purpose: The impact of neoadjuvant chemotherapy for locally advanced colorectal cancer has not yet been investigated; thus, this study aimed to examine the safety, feasibility, and oncological effects of neoadjuvant chemotherapy for locally advanced colorectal cancer.
Methods: In this multicenter study, we retrospectively reviewed the data of 83 locally advanced colorectal cancer patients (cT3/4 or N1/2) who received neoadjuvant chemotherapy followed by radical resection between April 2016 and September 2020. The NAC regimens were FOLFOX (5-fluorouracil, leucovorin, and oxaliplatin), XELOX (capecitabine and oxaliplatin), or SOX (S-1 and oxaliplatin). We evaluated the pathological responses as well as the short- and long-term outcomes.
Results: A pathological complete response was achieved in 4 patients (4.8%). Tumor down-staging and nodal down-staging were achieved in 57 (68.7%) and 49 (59.0%) patients, respectively. One patient (1.2%) experienced progressive disease. Postoperative complications occurred in 21 patients (25.3%). Multivariate analysis revealed that the pathological N positive status (p = 0.015; odds ratio, 4.458; 95% confidence interval, 1.331 to 7.9300) was an independent predictive factor for relapse-free survival.
Conclusion: Neoadjuvant chemotherapy for colorectal cancer could achieve good tumor control and down-staging without increasing the rate of complications. Appropriate preoperative treatment that can reduce the rate of the pathological nodepositive disease may improve oncological outcomes.
