597P Surgical quality for patients (pts) treated with neoadjuvant chemotherapy vs chemoradiation for locally advanced rectal cancer (LARC): PROSPECT (NCCTG N1048, alliance)

摘要: BackgroundRadiation with sensitizing fluoropyrimidine (5FUCRT) is a standard curative intent treatment for LARC. The PROSPECT trial compared FOLFOX chemotherapy with selective use of 5FUCRT (intervention) to 5FUCRT (control) for neoadjuvant treatment prior to total mesorectal excision (TME) for LARC and the primary endpoint of non-inferiority disease-free survival was met. Analyzing quality of surgery is key to interpreting the results of PROSPECT.MethodsTrial eligibility included cT2N+, cT3N-, cT3N+ rectal cancers deemed appropriate for neoadjuvant therapy prior to TME. Exclusions included tumors not amenable to sphincter preservation, T4 disease, threatened radial margins, or> 4 enlarged lymph nodes. Pts were randomized 1: 1 to 5FUCRT with 5040 cGy over 5.5 weeks with capecitabine or 5FU (control) or 6 cycles of mFOLFOX6 (intervention) followed by restaging. Secondary and post hoc …