Evaluation of the pathologic response to neoadjuvant treatment in rectal cancer. Experience at the Instituto de Cancerología de Medellín (Colombia, 2011-2017)

Palacios-Fuenmayor, L.J.; Naranjo-Isaza, A.M.; Serna-Ortiz, C.A.; Mosquera-Castro, D.A.; Arbeláez-Leon, L.M.; Gómez-Wolff, L.R.; García-García, Héctor Iván; Sánchez-Patiño, L.A.

doi:10.1016/j.rgmxen.2019.11.004

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Palacios-Fuenmayor et al achieved a rate of 17% for cPR. Their patients had higher disease-free survival in comparison to the others with partial or no response score [45]. By using the AJCC/CAP TRG system, in their multicenter cohort study, Chen et al found statistically significant differences between all four categories of TRG and that the inferior ones were correlated with worse survival (disease-free survival, overall survival, local recurrence-free survival, and distant metastasis-free survival).…”

Section: Discussionmentioning

confidence: 98%

Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer

Ulusoy¹,

Kamali²,

Nikolovski

2023

Current Oncology

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Background: Neoadjuvant chemoradiotherapy prior to surgery is the standard treatment for locally advanced rectal cancer. This consists in the patient’s complete pathological response being achieved with no residual tumor presence in the resected specimen, which results in survival improvement. Methods: This retrospective study aimed to examine the rate of complete pathological response in patients with advanced rectal cancer treated with neoadjuvant long-course chemoradiotherapy and to examine the survival differences between the different tumor regression grade (TRG) scores. Results: A total of 154 patients were operated prior to long-course chemoradiotherapy with a total of 50 Gy plus FOLFOX protocol. Complete pathologic response was achieved in 29 (18.8%) patients. There was no statistical difference for the different pathologic responses according to gender, type of surgery, and number of harvested lymph nodes. Mean survival for all the groups was 37.2 months. Survival within a different TRG score exhibited statistical significance (p = 0.006). Overall, the survival rate during the follow-up period was of 81.8%. Conclusions: The complete pathological response rate in this study was of 18.8%. High tumor regression grade scores (TRG0 and TRG1) had a survival rate of over 90% during follow-up. Multivariate analysis identified perineural invasion and tumor regression grade as independent factors that affect survival.

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Section: Discussionmentioning

confidence: 98%

Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer

Ulusoy¹,

Kamali²,

Nikolovski

2023

Current Oncology

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Predicting Factors of Complete Pathological Response in Locally Advanced Rectal Cancer

Latif

Shirkhoda

Rouhollahi

et al. 2022

Middle East J Dig Dis

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Background: Current treatment of choice for locally advanced rectal cancer is neoadjuvant chemoradiotherapy (neo-CRT) followed by surgical resection and adjuvant chemotherapy. Some patients may experience complete pathological response (cPR) after the neoadjuvant treatment. However, the predicting factors are still debated. Methods: In this registry-based retrospective cohort study, 258 patients with locally advanced rectal cancer were included. Patients were categorized into two groups with or without cPR. Logistic regression analysis was recruited to investigate the odds ratio for all independent variables, and those with significant results were included in multivariate regression analysis. Results: Achievement of cPR was 21.3%. The odds ratio of cPR was significantly lower when the tumor distance from the anal verge was>10 centimeters (OR=0.24, P=0.040). Also, the odds of cPR with N1 involvement in comparison with N0 involvement decreased for 0.41 (P=0.043). It was also true for patients with N2 involvement in comparison with N0 involvement (OR=0.31, P=0.031). Higher odds ratio of cPR was observed in patients who underwent surgery in>12 weeks after neo-CRT (OR=2.9, P=0.022). Furthermore, the odds of cPR decreased for 0.9 with increasing in carcinoembryonic antigen (CEA) level (P=0.044). Conclusion: Patients with rectal cancer in clinical stage II or lower, without the involvement of the lymphatic system at diagnosis, and with tumors located in the lower parts of the rectum, with lower levels of CEA, and longer duration between neo-CRT and surgery were more likely to achieve cPR after neo-CRT. With the current knowledge, the "wait and watch policy" is still debated and needs to be defined more precisely by upcoming studies.

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Evaluation of the pathologic response to neoadjuvant treatment in rectal cancer. Experience at the Instituto de Cancerología de Medellín (Colombia, 2011-2017)

Cited by 2 publications

References 9 publications

Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer

Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer

Predicting Factors of Complete Pathological Response in Locally Advanced Rectal Cancer

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