Is surgery necessary after complete clinical remission following neoadjuvant chemotherapy for early XXXX ?

@entity1 @entity0
PURPOSE: This retrospective analysis aimed to identify whether @entity0 @entity1 receiving radiotherapy alone following a complete clinical remission (cCR) to neoadjuvant chemotherapy had a worse outcome than those treated with surgery. @entity1 AND METHODS: One hundred thirty-six @entity1 who had achieved a cCR to neoadjuvant chemotherapy for early @entity0 were identified from a prospectively maintained database of 453 @entity1 . Of these, 67 @entity1 had undergone surgery as their primary locoregional therapy, and 69 @entity1 had radiotherapy alone. Outcome was assessed in relation to local recurrence-free survival, disease-free survival, and overall survival. RESULTS: Median follow-up was 63 months in the surgery group and 87 months in the no surgery group. Prognostic characteristics were well balanced between the two groups. For surgery and no surgery, respectively, there were no significant differences in disease-free survival or overall survival (5-year, 74% v 76%; 10-year, 60% v 70%, P =.9) between the two groups. There was a nonsignificant trend toward increased locoregional-only recurrence for the no surgery group (21% v 10% at 5 years; P =.09), but no long-term failures of local control. @entity1 in the no surgery group who also achieved an ultrasound complete remission had a 5-year local recurrence rate of only 8%. CONCLUSION: In @entity1 achieving a cCR to neoadjuvant chemotherapy, radiotherapy alone achieve survival rates as good as with surgery, but with higher local recurrence rates. Ultrasound may identify a low recurrence rate subgroup for assessing no surgery in a prospective trial.
