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Risk and location o...
Risk and location of distant metastases in patients with locally advanced rectal cancer after total neoadjuvant treatment or chemoradiotherapy in the RAPIDO trial
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- Bahadoer, Renu R. (author)
- Leiden Univ, Dept Surg, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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- Hospers, Geke A. P. (author)
- Univ Med Ctr Groningen, Dept Med Oncol, Hanzepl 1,Postbus 30-001, NL-9700 RB Groningen, Netherlands.;Univ Med Ctr Groningen, Dept Med Oncol, Hanzepl 1,Postbus 30-001, NL-9700 RB Groningen, Netherlands.
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- Marijnen, Corrie A. M. (author)
- Netherlands Canc Inst, Dept Radiat Oncol, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands.;Leiden Univ, Dept Radiat Oncol, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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- Peeters, Koen C. M. J. (author)
- Leiden Univ, Dept Surg, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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- Putter, Hein (author)
- Leiden Univ, Dept Med Stat & Bioinformat, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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- Dijkstra, Esmee A. (author)
- Univ Med Ctr Groningen, Dept Med Oncol, Hanzepl 1,Postbus 30-001, NL-9700 RB Groningen, Netherlands.
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- Kranenbarg, Elma Meershoek-Klein (author)
- Leiden Univ, Dept Surg, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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- Roodvoets, Annet G. H. (author)
- Leiden Univ, Dept Surg, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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- van Etten, Boudewijn (author)
- Univ Med Ctr Groningen, Dept Surg, Hanzepl 1,Postbus 30-001, NL-9700 RB Groningen, Netherlands.
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- Nilsson, Per J. (author)
- Karolinska Institutet
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- Glimelius, Bengt (author)
- Uppsala universitet,Cancerprecisionsmedicin
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- van de Velde, Cornelis J. H. (author)
- Leiden Univ, Dept Surg, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands.
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, ollaborative investigators (author)
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Leiden Univ, Dept Surg, Med Ctr, Albinusdreef 2,Postbus 9600, NL-2300 RC Leiden, Netherlands Univ Med Ctr Groningen, Dept Med Oncol, Hanzepl 1,Postbus 30-001, NL-9700 RB Groningen, Netherlands.;Univ Med Ctr Groningen, Dept Med Oncol, Hanzepl 1,Postbus 30-001, NL-9700 RB Groningen, Netherlands. (creator_code:org_t)
- Elsevier, 2023
- 2023
- English.
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In: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 185, s. 139-149
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Abstract
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- Introduction: Although optimising rectal cancer treatment has reduced local recurrence rates, many patients develop distant metastases (DM). The current study investigated whether a total neoadjuvant treatment strategy influences the development, location, and timing of metastases in patients diagnosed with high-risk locally advanced rectal cancer included in the Rectal cancer And Pre-operative Induction therapy followed by Dedicated Operation (RAPIDO) trial.Material and methods: Patients were randomly assigned to short-course radiotherapy fol-lowed by 18 weeks of CAPOX or FOLFOX4 before surgery (EXP), or long-course che-moradiotherapy with optional postoperative chemotherapy (SC-G). Assessments for metastatic disease were performed pre-and post-treatment, during surgery, and 6, 12, 24, 36, and 60 months postoperatively. From randomisation, differences in the occurrence of DM and first site of metastasis were evaluated.Results: In total, 462 patients were evaluated in the EXP and 450 patients in the SC-G groups. The cumulative probability of DM at 5 years after randomisation was 23% [95% CI 19-27] and 30% [95% CI 26-35] (HR 0.72 [95% CI 0.56-0.93]; P = 0.011) in the EXP and SC -G, respectively. The median time to DM was 1.4 (EXP) and 1.3 years (SC-G). After diagnosis of DM, median survival was 2.6 years [95% CI 2.0-3.1] in the EXP and 3.2 years [95% CI 2.3-4.1] in the SC-G groups (HR 1.39 [95% CI 1.01-1.92]; P = 0.04). First occurrence of DM was most often in the lungs (60/462 [13%] EXP and 55/450 [12%] SC-G) or the liver (40/462 [9%] EXP and 69/450 [15%] SC-G). A hospital policy of postoperative chemotherapy did not influence the development of DM.Conclusions: Compared to long-course chemoradiotherapy, total neoadjuvant treatment with short-course radiotherapy and chemotherapy significantly decreased the occurrence of me-tastases, particularly liver metastases.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Rectal cancer
- Total neoadjuvant therapy
- Distant metastases
- Metastatic pattern
Publication and Content Type
- ref (subject category)
- art (subject category)
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Bahadoer, Renu R ...
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Hospers, Geke A. ...
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Marijnen, Corrie ...
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Peeters, Koen C. ...
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Putter, Hein
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Dijkstra, Esmee ...
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Kranenbarg, Elma ...
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Roodvoets, Annet ...
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van Etten, Boude ...
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Nilsson, Per J.
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Glimelius, Bengt
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van de Velde, Co ...
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, ollaborative i ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Uppsala University
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Karolinska Institutet