Pathologic Response, When Increased by Longer Interval, Is a Marker but Not the Cause of  Good Prognosis in XXXX : 17-year Follow-up of the Lyon R90-01 Randomized Trial.

@entity5 @entity1 @entity15698 @entity1162
PURPOSE: The Lyon R90-01 randomized trial investigated whether the interval between preoperative radiation therapy and surgery influenced @entity5 outcome. Long-term results are reported here after a median follow-up of 17  years. METHODS AND MATERIALS: Between February 1991 and December 1995, 210 @entity1 from 29 French centers were randomly assigned (ratio of 1:1) to groups that waited either 2  weeks (short interval [SI]) or 6 to 8  weeks ( @entity1162 [ @entity1162 ]) between neoadjuvant radiation therapy and surgery. The primary endpoint was sphincter-preserving surgery. RESULTS: @entity1162 group showed a better pathologic response (complete response or few residual cells) after radiation therapy than the SI group (26% vs 10.3%, P=.015). A better pathologic response was associated in multivariate analysis with significant improvement of overall survival (pT: P=.0293 and pN: P=.0048) but it was irrespective of the interval duration. The median follow-up was 17.2  years. The 5-, 10-, 15-, and 17-year overall survival rates were, respectively, 66.8%, 48.7%, 40.0%, and 34.0% for the SI group and, respectively, 67.1%, 53.5%, 41.9%, and 34.0% for the @entity1162 group. There were no significant differences between groups in terms of survival (P=.7656) or local recurrence rates (SI: 14.4% vs @entity1162 : 12.1%, respectively; P=.6202). Of 24 local disease recurrences, 20 (83%) occurred during the first 2 postoperative years, and all but one (96%) occurred during the first 5 postoperative years. The rate of second new @entity5 was 9.4% (19 @entity1 ). CONCLUSIONS: The radiation-induced sterilization rate of the preoperative @entity5 specimen was a marker of good prognosis. The interval duration (the treatment being the same) although it is modifying the sterilization rate has no impact on survival. Radiation therapy did not postpone local recurrence, because the rate of local relapse after 5  years was low. @entity15698 after radiation therapy were unusual and should not influence treatment decisions in adults.
