Effect of postoperative adjuvant chemotherapy on the prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy*

Abstract

Abstract Objective The aim of this study was to investigate the effect of adjuvant chemotherapy (AC) on the prognosis of patients with ypT0-3N0 rectal cancer undergoing neoadjuvant chemoradiotherapy. Methods The study participants were 110 patients with locally advanced rectal cancer. Thirty-four patients did not receive postoperative AC treatment, and the other 76 patients received postoperative AC treatment. The differences in the 5-year overall survival (OS) and disease-free survival (DFS) between the two groups were compared. Results Age was an important determinant of the patients’ decision to undergo postoperative treatment. Patients who did not receive AC treatment were significantly older than those who received AC treatment (P < 0.05). The tumor location (distance above anal margin) in the AC group was significantly larger than that in the non-AC group (P < 0.05). Moreover, there was no significant difference in the 5-year DFS and OS between the two groups. Postoperative AC did not significantly improve the prognosis of patients with rectal cancer. Age, tumor differentiation, and the number of resected lymph nodes were independent factors affecting the OS of patients (P < 0.05). Older patients, patients with lower degree of tumor differentiation, and patients with <12 resected lymph nodes showed worse prognosis (P < 0.05). Conclusion Patients with rectal cancer whose ypT0-3N0 stage is reduced after neoadjuvant chemoradiotherapy, especially those without adverse prognostic factors, do not need AC after surgery.