Tumori Journal Abstract Book - October 2020 - 42

42	
resected colon cancer, with the major issue of OXA-related
neuropathy. The IDEA metanalysis showed a clear reduction in neuropathy incidence when CT is shortened from 6
to 3 months, but formally failed in demonstrating the noninferiority of the short regimen versus the standard.
Although the loss in 3-years DFS has been only 0.9%, it
generated a great debate and many professionals and opinion leaders didn't welcome the 3 months regimen as a new
standard. The aim of this retrospective trial is to explore
how the reduction of OXA exposure impacts on survival
outcomes in clinical practice.
Material and methods: Records of patients treated with
OXA-based adjuvant CT for high risk stage II (pT4N0) or
stage III (any pT N+) colon cancer at our institution from
2011 to 2015 were collected. Patients were divided into 3
different groups based on the total amount of OXA cycles
received: low exposure (A: 1-2 CAPOX cycles or 1-4
FOLFOX cycles); intermediate (B: 3-6 CAPOX cycles or
4-9 FOLFOX cycles); high (C: 7-8 CAPOX cycles or
10-12 FOLFOX cycles). OXA could have been withdrawn
for any reason and FP monotherapy withheld. The primary
endpoint was to prove the non-inferiority of DFS for B
over C, with maximum Δ set to -20%.
Results: The search retrieved full data for 50 patients (60%
males, mean age 65 y). The mean dose of OXA delivered
was 72,6% of the full dose. The first cause of OXA withdrawal was toxicity, mainly neuropathy. Patient division by
OXA exposure was: A = 7 (14%), B = 17 (34%), C = 26
(52%). 3-y DFS for B was 80,7% vs 58,4% for C (Noninferiority HR 0.41; 90% C.I. 0.14-1.19; p=0.049). OS HR
was 0.4 (90% C.I. 0.11-1.46, p=0.21). Multivariate analysis
did not show any subgroup significantly associated with
survival. The most frequent G3-4 adverse events were diarrhea (4%), neutropenia (4%) and neuropathy (42%).
Neuropathy was higher in B than in C (p=0.014).
Conclusions: This study confirmed that adjuvant OXA
therapy for high risk stage II/stage III resected colon cancer may be shortened without affecting survival outcomes.
The role of FP monotherapy beyond oxaliplatin withdrawal remains unclear.

B24
Lymph node status after
personalized neoadjuvant chemo
radiotherapy: comparative
analysis on a monoinstitutional
retrospective series with followup at 2 years
Poti' O.1, De Giorgi D.2, Ingrosso D.3, Marcucci G.4, Mancarella S.5
1

U.O Chirurgia P.O San Giuseppe Da Copertino ASL Lecce, Copertino, Lecce;
U.O. Chirurgia P.O. San Giuseppe Da Copertino ASL Lecce, Copertino; 3U.O.
Chirurgia P.O. Sacro Cuore Gallipoli ASL Lecce, Gallipoli; 4U.O. Chirurgia P.O.
San Giuseppe Da Copertino ASL Lecce, Copertino; 5U.O. Oncologia Medica
P.O. Santa Caterina Novella Galatina ASL Lecce, Galatina
2

Tumori Journal 106(2S)
Background: One of the topics of major discussion in
conservative surgery of the rectum subjected to neoadjuvant chemo-radiotherapy is the status of the lymph nodes
that cannot be performed for the omitted lymphectomy.
Materials and methods: In this work we studied two cases
retrospectively over a period of 3 years (2015-2018), concerning the surgery of the rectum subjected to neoadjuvant
chemo-radiotherapy. We included in the group A pz cT3,
cT4, with each N, M0 who performed a complete cycle of
personalized CHRT and who underwent rectal resection
with standard lymphectomy and complete excision of the
mesorect. In addition, we included patients who had a complete response highlighted on T as a complete pathological
response on TEM (transanal resection), with negative lymph
node metastasis. in the group B we included patients with
middle / high and high rectal neoplasia pT3, T4 with any N
and M0 not subjected to neoadjuvant treatments, who performed a standard rectal resection with complete excision of
the mesorectum and surgical R0.
Results: In group A we treated 20 patients, obtaining 6
(30%) complete pathological response (3 pCR with resection, 3 pCR with TEM). In 3 (15%) patients in this group
there were lymph node metastases, the total number of
lymph nodes involved was 4. In three pz with N +, the
average ratio (LN ratio) between pathological and LN
removed was 2 / 9.2 / 18.1 / 14 (ln ratio 0.2.0.1.0.07 with
average 0.12). Regarding tumour (T) it was downstaging in
16 patients, from ypT2 to ypT0,end metastatic lymph nodes
were found in 2 pz with ypT3 and 1ypT2. In group B out of
12 patients we had 4 patients with lymph node metastases
(equal to 33%), The total number of lymph nodes involved
was 18 in the four pz N +. The relationship between pathological and removed lymph nodes (LN ratio) was 15 / 18.1
/ 9.1 / 6.1 / 8 (LN ratio, 0.8,0.1,0.6,0.12 with average 0.40)
Comparing the two groups, the neoadjuvant CHRT statistically reduced the incidence of lymph node metastases in
the population under examination, but also the number of
lymph nodes involved in the metastatic process.
Conclusions: Personalized neo-adjuvant therapy allows a
significant reduction of lymph node metastases, determining in selected cases a conservative approach to surgical
therapy of the rectum. From our evidence, an extension of
the neaodiuvamte therapy may also appear indicated even
in selected patients with intraperitoneal rectum.

B25
TAS-102 with bevacizumab in
patients with chemorefractory
metastatic colorectal cancer.
Real fife study
Miano S.1, Francini G.2, Petrioli R.1, Francini E.3, Martellucci I.1,
Marsili S.1, Vannini A.1, Pascucci A.1
1

UOC Oncologia Medica AOUS, Siena; 2Università degli Studi, Siena;
Università degli Studi, Firenze

3



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
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