Postoperative Chemotherapy May Not Be Necessary for Patients With ypN0-Category After Neoadjuvant Chemoradiotherapy of Rectal Cancer

摘要: After neoadjuvant radiochemotherapy and surgery, there is no general agreement about whether postoperative chemotherapy necessary. With the help of clinical pathohistologic data, prognostic factors were determined as a basis for decision to spare patient additional or urgently recommend it. Ninety-five patients treated with 5-fluorouracil-based (November 4, 1997 June 15, 2004) without distant metastases an R0 (microscopically complete) resection evaluated. Adjuvant (5-fluorouracil 5-fluorouracil/folinic acid) was given 65 95 (68.4 percent). The disease-free survival rate after 36 months chosen target parameter (median follow-up, months). five-year all 80.3 ± 5.6 percent; 78.1 5.1 local control 94.2 percent. In univariate multivariate analysis survival, lymph node status (ypN) only significant parameter. Disease-free (36 months) (ypN0) excellent, independent they had received (n = 43; 87.5 6.0 percent) not 29; 87.7 6.7 Patients ypN2 have, despite chemotherapy, poor at 30 17.6 percent months. These retrospective data suggest that, some patients, can be spared. For status, intensification should considered. Further evaluation in prospective studies recommended.