Rectal Cancer Complete Response Outcomes in a Community-Based Hospital Comparable with Large Cancer Centers When Multidisciplinary Approach to Rectal Cancer Is Used

Am Surg. 2019 May 1;85(5):530-538.

Abstract

Achievement of pathologic complete response (pCR) in patients with locally advanced rectal cancer correlates with improved prognosis relative to non-pCR counterparts. Such correlations are not well established in the context of a community-based hospital. This study aims to examine pCR rates, recurrences, and survival data for locally advanced rectal cancer patients in community settings. A single-center retrospective chart review was performed at a community-based hospital. Study population consisted of 119 patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy, followed by surgical resection. Patients with a history of metastasis, inflammatory bowel disease, hereditary cancer syndromes, concurrent or prior malignancy, and emergent surgery were excluded. Twenty-four patients (20.2%) achieved pCR. Across both groups, all demographics and perioperative characteristics were comparable. The five-year survival was 73.7 per cent in the non-pCR group and 95.8 per cent in the pCR group (P = 0.0243). At five years, 27.7 per cent of the non-pCR group had a recurrence, as compared with none in the pCR group (P = 0.0018). Based on our study, we believe that a multidisciplinary approach to rectal cancer used at a community-based hospital can achieve oncological outcomes and survival benefits similar to those of larger academic tertiary care institutions.

MeSH terms

  • Aged
  • Cancer Care Facilities*
  • Chemoradiotherapy
  • Disease-Free Survival
  • Female
  • Hospitals, Community*
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local / epidemiology*
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / therapy*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome