{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:25:05Z","timestamp":1780615505967,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We report the short\/mid\u2010term results of surgery for high\u2010risk locally advanced rectal cancer (LARC) after neoadjuvant chemotherapy (NAC, four courses of S\u20101\u2009+\u2009oxaliplatin+ bevacizumab) without radiotherapy with the primary aim of ypT0\u20102.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>High\u2010risk LARC was defined as cT4b, mesorectal fascia (MRF) \u22641\u2009mm (MRF+), or lateral lymph node metastasis (cLLN+) on high\u2010resolution MRI. The planned 32 cases from April 2018 to December 2021 were all included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 10 patients at cT4b (31.2%), 26 MRF+ (81.3%), and 22 cLLN+ (68.8%). Thirteen (40.6%) underwent NAC after a colostomy for stenosis. NAC was completed in 26 (81.2%) cases. Grade 3 or higher adverse events occurred in six (18.7%). One patient developed progressive disease (3.2%). Eleven were ycT0\u20103MRF\u2010LLN\u2010 (34.3%). Curative\u2010intent surgery was performed on 31, with sphincter\u2010preserving surgery in 20, abdominoperineal resection in nine, total pelvic exenteration in two, and lateral lymph node dissection in 24. Two had R1\/2 resection (6.4%). A Grade 3 or higher postoperative complication rate occurred in 3.2%. Pathological complete response and ypT0\u20102 rates were 12.9% and 45.1%. Three\u2010year disease\u2010free survival rates (3yDFS) for ypT0\u20102 and ypT \u22653 were 81.2%, 46.6% (<jats:italic>p<\/jats:italic>\u2009=\u20090.061), and 3\u2010year local recurrence rates (3yLR) were 0%, 48.8% (<jats:italic>p<\/jats:italic>\u2009=\u20090.015). 3yDFS for ycT0\u20103MRF\u2010LLN\u2010 and ycT4\/MRF+\/LLN+ were 87.5%, 48.0% (<jats:italic>p<\/jats:italic>\u2009=\u20090.031) and 3yLR were 0%, 42.8% (<jats:italic>p<\/jats:italic>\u2009=\u20090.045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>NAC yielded a clinically significant effect in about half of high\u2010risk LARC patients. If NAC alone is ineffective, radiotherapy should be added, even if extended surgery is intended.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.12720","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T07:08:20Z","timestamp":1689836900000},"page":"71-79","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Neoadjuvant S\u20101 and oxaliplatin plus bevacizumab therapy for high\u2010risk locally advanced rectal cancer: A prospective multicenter phase <scp>II<\/scp> study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0238-2845","authenticated-orcid":false,"given":"Takuya","family":"Miura","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine  Hirosaki 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