Lee L, et al. – Researchers performed a comparison of combined chemoradiation (CRT) and local excision (LE) versus radical surgery (RS) for T2 rectal cancer. Findings revealed that CRT with LE for T2N0M0 rectal cancer was not associated with worse overall survival (OS) compared to RS, and could be a viable treatment modality.

Methods

• Researchers searched the 2004–2014 National Cancer Database for patients with T2N0M0 rectal cancer undergoing LE with neoadjuvant(NA-CRT + LE) or adjuvant(LE + Adj-CRT) CRT, or RS.
• 5-year overall survival (OS) was primarily assessed.
• They used Cox proportional hazards to determine the independent effect of treatment on OS.

Results

• This study included 4822 patients (4367 RS, 242 CRT + LE, 213 LE + Adj-CRT).
• Patients were followed-up for a mean duration of 48.6 (SD28.5) months.
• Observations revealed no differences in patient characteristics, but more high-risk features in the LE + Adj-CRT group.
• No differences in 90-day mortality were observed.
• Similar five-year OS was evident (RS 77.4% vs. CRT + LE 76.1% vs. LE + Adj-CRT 79.7%, p = 0.786).
• Older age, male gender, and higher Charlson score seemed to have independent association with worse OS, whereas treatment type indicated no association.
• On excluding 90-day mortality, LE + Adj-CRT seemed independently associated with worse OS compared to RS.