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urn:hdl:2445/111525 Adjuvant therapy sparing in rectal cancer achieving complete response after chemoradiation García-Albéniz, Xavier Gallego, Rosa Hofhteinz, Ralf Dieter Fernández Esparrach, Glòria Ayuso Colella, Juan Ramón Bombí, Josep Antoni Conill, Carles Cuatrecasas Freixas, Miriam Delgado Rivilla, Salvadora Ginès i Gibert, M. Àngels Miquel Morera, Rosa Pagès Llinàs, M. (Mario) Pineda, Estela Pereira, María Verónica Sosa, Aarón Reig Torras, Oscar Victoria, Iván Feliz, Luis Lacy Fortuny, Antonio Ma. de Castells Garangou, Antoni Burkholder, Iris Hochhaus, Andreas Maurel Santasusana, Joan Càncer colorectal Radioteràpia Quimioteràpia del càncer Cirurgia laparoscòpica Estudi de casos Colorectal cancer Radiotherapy Cancer chemotherapy Laparoscopic surgery Case studies AIM: To evaluate the long-term results of conventional chemoradiotherapy and laparoscopic mesorectal excision in rectal adenocarcinoma patients without adjuvant therapy. METHODS: Patients with biopsy-proven adenocarcinoma of the rectum staged cT3-T4 by endoscopic ultrasound or magnetic resonance imaging received neoadjuvant continuous infusion of 5-fluorouracil for five weeks and concomitant radiotherapy. Laparoscopic surgery was planned after 5-8 wk. Patients diagnosed with ypT0N0 stage cancer were not treated with adjuvant therapy according to the protocol. Patients with ypT1-2N0 or ypT3-4 or N+ were offered 5-fluorouracil-based adjuvant treatment on an individual basis. An external cohort was used as a reference for the findings. RESULTS: One hundred and seventy six patients were treated with induction chemoradiotherapy and 170 underwent total mesorectal excision. Cancer staging of ypT0N0 was achieved in 26/170 (15.3%) patients. After a median follow-up of 58.3 mo, patients with ypT0N0 had five-year disease-free and overall survival rates of 96% (95%CI: 77-99) and 100%, respectively. We provide evidence about the natural history of patients with localized rectal cancer achieving a complete response after preoperative chemoradiation. The inherent good prognosis of these patients will have implications for clinical trial design and care of patients. CONCLUSION: Withholding adjuvant chemotherapy after complete response following standard neoadjuvant chemoradiotherapy and laparoscopic mesorectal excision might be safe within an experienced multidisciplinary team. 2017-05-25T07:54:10Z 2017-05-25T07:54:10Z 2014-11-14 2017-05-25T07:54:11Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.3748/wjg.v20.i42.15820 World Journal of Gastroenterology, 2014, vol. 20, num. 42, p. 15820-15829 https://doi.org/10.3748/wjg.v20.i42.15820 cc-by-nc (c) García-Albéniz, X. et al., 2014 http://creativecommons.org/licenses/by-nc/3.0/es info:eu-repo/semantics/openAccess Baishideng Publishing Group Articles publicats en revistes (Fonaments Clínics)