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28.01.2020 | Original Article | Ausgabe 8/2020

Surgery Today 8/2020

Importance of the neoadjuvant rectal (NAR) score to the outcome of neoadjuvant chemotherapy alone for locally advanced rectal cancer

Zeitschrift:
Surgery Today > Ausgabe 8/2020
Autoren:
Toshiki Mukai, Keisuke Uehara, Toshisada Aiba, Atsushi Ogura, Toyonori Tsuzuki, Aya Tanaka, Masanori Sando, Noriyuki Ohara, Yusuke Sato, Norifumi Hattori, Goro Nakayama, Yasuhiro Kodera, Masato Nagino
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Abstract

Purpose

The neoadjuvant rectal (NAR) score is a promising indicator of survival after preoperative chemoradiotherapy for rectal cancer. However, its effectiveness after neoadjuvant chemotherapy (NAC) alone has not been fully investigated.

Methods

We analyzed data retrospectively on 61 patients with rectal cancer, who received NAC followed by surgical resection between 2010 and 2015, and evaluated the impact of the NAR score on survival.

Results

The median NAR score was 14.9. Of the 61 patients, 13, 35, and 13 were classified as having NAR-low (< 8), NAR-intermediate (8–16), and NAR-high (> 16) scores, respectively. The median observation period was 49.0 months. According to the NAR score, the 3-year DFS in the NAR-low group was 100%, which was significantly better than that in the NAR-intermediate (64.8%, p = 0.041), and NAR-high (61.5%, p = 0.018) groups. When the NAR-intermediate and NAR-high groups were investigated as a single high-risk group, the 3-year DFS of the patients who received adjuvant chemotherapy was 88.7%, which was significantly better than that of the patients who did not receive adjuvant chemotherapy (53.3%, p = 0.042).

Conclusions

The NAR score may predict the DFS and could serve as a favorable indicator of adjuvant chemotherapy after NAC alone.

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