Patterns of care and outcomes for adjuvant treatment of pT3N0 rectal cancer using the National Cancer Database.
Journal of Gastrointestinal Oncology
Background: The standard of care in locally advanced rectal cancer is preoperative chemoradiation followed by surgical resection. However, the optimal treatment paradigm is currently controversial for patients with pathological T3N0 (pT3N0) in the era of total mesorectal excision (TME). Given the paucity of data, we conducted an analysis using the National Cancer Database (NCDB) to identify patterns of care and outcomes.
Methods: We utilized the NCDB to identify 7,836 non-metastatic, pT3N0 rectal cancer patients who did not receive neoadjuvant therapy from 2004-2014. Univariate and multivariable analysis for factors affecting treatment selection were completed using logistic regression. Overall survival (OS) analyses were completed using Cox regression modeling, incorporating propensity scores with inverse probability of treatment weighting (IPTW) and conditional landmark analysis.
Results: There was a significant improvement in OS in patients receiving adjuvant chemotherapy (P
Conclusions: Practice patterns vary in the management of pT3N0 rectal cancer patients. This analysis suggests that the use of adjuvant therapy, particularly adjuvant chemotherapy with or without RT, appears to improve OS.
Quinn TJ, Rajagopalan MS, Gill B, Mehdiabadi SM, Kabolizadeh P. Patterns of care and outcomes for adjuvant treatment of pT3N0 rectal cancer using the National Cancer Database. J Gastrointest Oncol. 2020 Feb;11(1):1-12. doi: 10.21037/jgo.2019.10.02. PMID: 32175100; PMCID: PMC7052766.