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OPRA (view source)

Revision as of 23:48, 16 February 2025

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==Major Points==
==Major Points==
* need to make this more paragraph form - EA
The OPRA trial randomized patients with stage II and III rectal cancer to either induction chemoradiotherapy with consolidation chemotherapy (CRT-CNCT) or induction chemotherapy followed by chemoradiotherapy (INCT-CRT). Patients with a complete or near-complete clinical response were managed with WW, while incomplete responses underwent TME. The trial demonstrated equivalent disease-free survival, overall survival, and distant metastasis free survival. INCT-CRT demonstrated superior rates of organ preservation (53% vs. 41%) and lower rates of tumor regrowth (27% vs. 40%).  
 
* The OPRA trial evaluated the efficacy of organ preservation in rectal cancer using TNT and selective WW or total mesorectal excision (TME) based on tumor response.
* 324 patients with stage II-III rectal adenocarcinoma were randomized to INCT-CRT or CRT-CNCT and treated with TNT (systemic chemotherapy and chemoradiotherapy).
* Patients were restaged after TNT; those with a complete or near-complete clinical response were managed with WW, while others underwent TME.
* Primary endpoint: 3-year disease-free survival. Secondary endpoints: TME-free survival, local recurrence-free survival, and distant metastasis-free survival.
* At 3 years, disease-free survival was 76% in both INCT-CRT and CRT-CNCT groups, comparable to historical controls.
* Organ preservation rates were 41% (64/158) for INCT-CRT and 53% (87/166) for CRT-CNCT (p=0.01).


==Guidelines==
==Guidelines==
Edadams916
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