Clinical outcome in patients with complete pathologic response (pT0) to preoperative irradiation/chemo-irradiation operated for locally advanced or locally recurrent rectal cancer

Abstract

pT0 after preoperative irradiation is associated with improved survival for pT0 cases of PLA. Our studies on pT0 LR was suggestive of an improvement in this group as well.

Magnetic resonance-guided histopathology for improved accuracy of tumor response evaluation of neoadjuvant treatment in organ-infiltrating rectal cancer

“…On the other hand, organ-infiltrating rectal cancer is associated both with a noticeably low rate of complete RT/CRT response [9] and late disease recurrence [10]. Of notice, in a study of rectal cancer patients with organ-infiltrating disease receiving neoadjuvant RT/CRT, we found that the subsequent preoperative MR examination in a number of cases did not display histologically confirmed residual tumor scattered within fibrosis or mucin that had replaced the tumor's primary extension in the surgical specimen [11].…”

“…Importantly, the histopathologic response is increasingly being employed and accepted as a primary treatment endpoint, and has extensively been used as surrogate marker of therapeutic efficacy in prospective studies of neoadjuvant therapy in rectal cancer [5]. Additionally, some investigators have been advocating a ''wait-and-see'' approach in rectal cancer patients achieving complete clinical response [6-8], thereby basing further management of these patients to a considerable extent on the interpretation of imaging outcome information.On the other hand, organ-infiltrating rectal cancer is associated both with a noticeably low rate of complete RT/CRT response [9] and late disease recurrence [10]. Of notice, in a study of rectal cancer patients with organ-infiltrating disease receiving neoadjuvant RT/CRT, we found that the subsequent preoperative MR examination in a number of cases did not display histologically confirmed residual tumor scattered within fibrosis or mucin that had replaced the tumor's primary extension in the surgical specimen [11].…”

Oncologic Outcome of ypT1-2N0 Rectal Cancer After Neoadjuvant Chemoradiotherapy Compared With pT1-2N0 Rectal Cancer

“…It is well known that the complete tumor response to preoperative CRT is associated with an excellent prognosis. [8][9][10][11][12] In addition, patients with ypN0 rectal cancer are reported to show a better prognosis than those with lymph node-positive disease after receiving preoperative CRT. 3,4,14 However, there are a few studies comparing the prognosis between patients who underwent preoperative CRT and those who did not undergo preoperative CRT.…”

“…However, the prognostic ability of pathologic T1-2N0 rectal cancer after neoadjuvant chemotherapy and radical surgery remains unclear and undetermined. Although it is well known that complete pathologic response to chemoradiation therapy is associated with good prognosis, [8][9][10][11][12] there are few studies assessing the oncologic outcome of patients with ypT1-2N0 rectal cancer who underwent preoperative chemoradiation therapy. 13 Therefore, it is necessary to assess whether patients with ypT1-2N0 rectal cancer show similar excellent prognosis compared with those with pT1-2N0 rectal cancer.…”

A prospective analysis of patient outcome following treatment of T3 rectal cancer with neo-adjuvant chemoradiotherapy and transanal excision

“…This is however little information concerning the effects of neoadjuvant therapy on lymph node metastases. Neo-adjuvant therapy results in downstaging of the primary tumour [23] with complete pathological response [6,22] in up to 20% of patients. Recent evidence suggests that lymph node metastases are rare in patients who have had complete or near complete response of the primary tumour to neo-adjuvant CRXT [2,17].…”