Neoadjuvant CapeOx therapy followed by sphincter-preserving surgery for lower rectal cancer

Taishi Hata, Hidekazu Takahashi, Daisuke Sakai, Naotsugu Haraguchi, Junichi Nishimura, Toshihiro Kudo, Matsuda Chu, Ichiro Takemasa, Satoh Taroh, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: This retrospective study investigates the safety of neoadjuvant chemotherapy with oxaliplatin capecitabine (CapeOx), followed by laparoscopic surgery, for lower rectal cancer, and its efficacy in preserving the sphincter. Methods: Ten patients with diagnosed lower rectal cancer received three or four cycles of neoadjuvant CapeOx chemotherapy, prior to undergoing low anterior resection or intersphincteric resection, with total mesorectal excision. The primary outcomes were R0 resection and the rate of sphincter preservation. Results: Nine patients completed CapeOx as scheduled and a partial response was achieved in four; thus, the overall response rate was 40% (n = 4/10). After surgical intervention, 80% of tumors displayed downstaging. Postoperative anastomosis leakage developed in one patient. The distance from the anal verge to the tumor increased by 60% (median 1.5 cm) after CapeOx treatment. The anal sphincter was preserved in all patients and all pathological distal and radial margins were negative (R0 resections). A pathological complete response was achieved in one patient. Conclusions: Neoadjuvant CapeOx chemotherapy is a promising approach, because it extended the distance from the anus to the tumor. Subsequent laparoscopic intervention for advanced lower rectal cancer could allow for safe preservation of the sphincter.

Original languageEnglish
Pages (from-to)1372-1377
Number of pages6
JournalSurgery today
Volume47
Issue number11
DOIs
Publication statusPublished - Nov 1 2017
Externally publishedYes

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Neoadjuvant Therapy
Rectal Neoplasms
oxaliplatin
Anal Canal
Drug Therapy
Neoplasms
Laparoscopy
Retrospective Studies
Safety

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Hata, T., Takahashi, H., Sakai, D., Haraguchi, N., Nishimura, J., Kudo, T., ... Mori, M. (2017). Neoadjuvant CapeOx therapy followed by sphincter-preserving surgery for lower rectal cancer. Surgery today, 47(11), 1372-1377. https://doi.org/10.1007/s00595-017-1527-5

Neoadjuvant CapeOx therapy followed by sphincter-preserving surgery for lower rectal cancer. / Hata, Taishi; Takahashi, Hidekazu; Sakai, Daisuke; Haraguchi, Naotsugu; Nishimura, Junichi; Kudo, Toshihiro; Chu, Matsuda; Takemasa, Ichiro; Taroh, Satoh; Mizushima, Tsunekazu; Doki, Yuichiro; Mori, Masaki.

In: Surgery today, Vol. 47, No. 11, 01.11.2017, p. 1372-1377.

Research output: Contribution to journalArticle

Hata, T, Takahashi, H, Sakai, D, Haraguchi, N, Nishimura, J, Kudo, T, Chu, M, Takemasa, I, Taroh, S, Mizushima, T, Doki, Y & Mori, M 2017, 'Neoadjuvant CapeOx therapy followed by sphincter-preserving surgery for lower rectal cancer', Surgery today, vol. 47, no. 11, pp. 1372-1377. https://doi.org/10.1007/s00595-017-1527-5
Hata T, Takahashi H, Sakai D, Haraguchi N, Nishimura J, Kudo T et al. Neoadjuvant CapeOx therapy followed by sphincter-preserving surgery for lower rectal cancer. Surgery today. 2017 Nov 1;47(11):1372-1377. https://doi.org/10.1007/s00595-017-1527-5
Hata, Taishi ; Takahashi, Hidekazu ; Sakai, Daisuke ; Haraguchi, Naotsugu ; Nishimura, Junichi ; Kudo, Toshihiro ; Chu, Matsuda ; Takemasa, Ichiro ; Taroh, Satoh ; Mizushima, Tsunekazu ; Doki, Yuichiro ; Mori, Masaki. / Neoadjuvant CapeOx therapy followed by sphincter-preserving surgery for lower rectal cancer. In: Surgery today. 2017 ; Vol. 47, No. 11. pp. 1372-1377.
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abstract = "Purpose: This retrospective study investigates the safety of neoadjuvant chemotherapy with oxaliplatin capecitabine (CapeOx), followed by laparoscopic surgery, for lower rectal cancer, and its efficacy in preserving the sphincter. Methods: Ten patients with diagnosed lower rectal cancer received three or four cycles of neoadjuvant CapeOx chemotherapy, prior to undergoing low anterior resection or intersphincteric resection, with total mesorectal excision. The primary outcomes were R0 resection and the rate of sphincter preservation. Results: Nine patients completed CapeOx as scheduled and a partial response was achieved in four; thus, the overall response rate was 40{\%} (n = 4/10). After surgical intervention, 80{\%} of tumors displayed downstaging. Postoperative anastomosis leakage developed in one patient. The distance from the anal verge to the tumor increased by 60{\%} (median 1.5 cm) after CapeOx treatment. The anal sphincter was preserved in all patients and all pathological distal and radial margins were negative (R0 resections). A pathological complete response was achieved in one patient. Conclusions: Neoadjuvant CapeOx chemotherapy is a promising approach, because it extended the distance from the anus to the tumor. Subsequent laparoscopic intervention for advanced lower rectal cancer could allow for safe preservation of the sphincter.",
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AU - Kudo, Toshihiro

AU - Chu, Matsuda

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AU - Doki, Yuichiro

AU - Mori, Masaki

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