Preliminary outcome of a treatment strategy based on perioperative chemotherapy and surgery in patients with locally advanced colon cancer

• Published in: Colorectal disease 2013-05, Vol.15 (5), p.552-557
• Main Authors: Arredondo, J., Pastor, C., Baixauli, J., Rodríguez, J., González, I., Vigil, C., Chopitea, A., Hernández-Lizoáin, J. L.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Capecitabine; Chemotherapy, Adjuvant; Colectomy - adverse effects; Colonic Neoplasms - pathology; Colonic Neoplasms - therapy; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Female; Fluorouracil - administration & dosage; Fluorouracil - analogs & derivatives; Humans; Length of Stay; Locally advanced colon cancer; Male; Middle Aged; Neoadjuvant Therapy; neoadjuvant treatment; Neoplasm Staging; Operative Time; Organoplatinum Compounds - administration & dosage; Positron-Emission Tomography; stage III colon cancer; Survival Rate; Tomography, X-Ray Computed
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.12119

Aim Preoperative chemotherapy followed by radical surgery is an attractive treatment for locally advanced colon cancer (LACC) given the promising results of this approach in other locally advanced tumours. The study evaluates the outcome and treatment‐related complications of perioperative oxaliplatin‐ and capecitabine‐based chemotherapy and surgery for clinical Stage III colon cancer. Method Twenty‐two consecutive patients with a CT‐staged LACC were included. All were staged at baseline and before surgery. Surgery‐related complications and oncological outcome were determined. Results Toxicity was manageable, with 19/22 patients completing the planned chemotherapy protocol. The median time from initial diagnosis to surgery was 65.5 days. The median time from the end of chemotherapy to surgery was 22 days. After neoadjuvant treatment, tumour reduction of 69.5% was observed by CT scan and a 59.9% decrease of SUVmax (standard uptake value) was achieved on positron emission tomography/CT. No progressive disease was reported during preoperative chemotherapy and surgery was performed in all 22 patients. Four patients developed postoperative complications. After a median postoperative follow‐up of 14.4 months, the actuarial overall and disease‐free survival rates were 100 and 90%. Conclusion Neoadjuvant chemotherapy followed by surgery and chemotherapy for LACC is safe without apparent increase of early and medium‐term complications.