Long-term Prognosis Of Neoadjuvant Chemotherapy In The Simultaneous Surgical Treatment Of Colon Cancer

Objective: To investigate the effect of preoperative neoadjuvant chemotherapy on resectable patients with locally advanced colon cancer,including postoperative survival rate and local recurrence rate.To evaluate the value of neoadjuvant chemotherapy in patients with locally advanced resectable colon cancer.Methods:Part ?: Retrospective analysis of clinical data of 124 patients with resectable locally advanced colon cancer in a gastrointestinal surgery of the Affiliated Hospital of Chengde Medical College from January 2010 to December 2014,divided into adjuvant chemotherapy group according to whether the patients received neoadjuvant chemotherapy before surgery and surgery group.The surgical methods are all CME surgery.The short-term curative effect,long-term curative effect and incidence of complications were compared between the two groups.Part ?: To explore the long-term efficacy and local recurrence rate of different neoadjuvant chemotherapy regimens for colon cancer patients before surgery.The computer searched CNKI,Wanfang,Weipu,www.pubmed.cn and other databases,the search terms were: preoperative adjuvant chemotherapy regimen,colon cancer and so on;the search time is as of January 2020.Two professional appraisers of our hospital separately extracted and verified the quality and data of the selecteddocuments,and verified the results,using RevMan5.2 software for meta-analysis.Results: 1.The preoperative clinical stage of the adjuvant chemotherapy group was lower than that of the control group and the preoperative tumor diameter was lower than that of the control group(P<0.05).However,there were no statistically significant differences between the two groups in operation time,average hospital stay,number of lymph node dissection(P>0.05).2.The resection rate and 3-year survival rate in the adjuvant chemotherapy group were higher than those in the control group(P<0.05),while the recurrence rate were lower than those in the control group(P<0.05).3.Independent risk factors affecting the long-term prognosis of colon cancer patients included tumor differentiation degree,preoperative pathological stage,increased CEA level(P<0.05).4.The results of meta-analysis showed that preoperative adjuvant chemotherapy had no significant effect on the 5-year survival rate of patients compared with the operation group alone(P>0.05),while preoperative adjuvant chemotherapy could reduce the postoperative recurrence rate of colon cancer patients(P<0.05).Conclusion:1.According to the single-center study,preoperative neoadjuvant chemotherapy can improve the rate of complete resection of surgical lesions and the three-year survival rate of locally advanced patients,and reduce the rate of postoperative recurrence.2.According to the single-center study,the long-term survival rate of locally advanced colon cancer is mainly related to the degree of tumor differentiation,local stage before treatment,postoperative and postoperative CEA level.3.According to the results of meta-analysis,neoadjuvant chemotherapy was considered to have no significant adverse effect on the 3-year survival rate of colon cancer patients,and could reduce the recurrence rate of colon cancer.The development of targeted neoadjuvant chemotherapy based on the patients' conditions could be implemented in clinical practice.