Abstract
BackgroundPredictive factors of pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) are still not identified. The purpose of this study was to define them.Materials and MethodsData from consecutive LARC patients treated between January 2008 and June 2014 at our Institution were included in the analysis. All patients were treated with a long course of nCRT. Demographics, initial diagnosis and tumor extension details, as well as treatment modalities characteristics were included in the univariate and logistic regression analysis.ResultsIn total 99 patients received nCRT, of whom 23 patients (23.2%) achieved pCR. Patients with and without pCR were similar in term of age, sex, comobidities, BMI and tumor characteristics. Multivariate logistic regression indicated that pre-treatment tumor size ≤ 5 cm was a significant predictor for pCR (p = 0.035), whereas clinical N stage only showed a positive trend (p = 0.084).ConclusionsTumor size at diagnosis could be used to predict pCR, and thus to individualize therapy in LARC patients management. Validation in other studies is needed.
Highlights
Neoadjuvant chemoradiotherapy is the standard treatment in locally advanced rectal cancer (LARC), due to the proven benefit in term of local recurrence and sphincter preservation [1,2]
Patients with and without pathologic complete response (pCR) were similar in term of age, sex, comobidities, BMI and tumor characteristics
Multivariate logistic regression indicated that pre-treatment tumor size ≤ 5 cm was a significant predictor for pCR (p = 0.035), whereas clinical N stage only showed a positive trend (p = 0.084)
Summary
Neoadjuvant chemoradiotherapy (nCRT) is the standard treatment in locally advanced rectal cancer (LARC), due to the proven benefit in term of local recurrence and sphincter preservation [1,2]. Based on the observation that a greater tumor regression to nCRT resulted in superior survival, nowadays pathologic complete response (pCR) rate is becoming a focus of interest [3]. Nowadays it is assumed that all LARC are a homogenous group and validation of predictive factors could be useful to stratify patients to receive investigational approaches [5,6]. Predictive factors of pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) are still not identified.
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