Abstract
The response to neoadjuvant chemoradiation therapy is an important prognostic factor for locally advanced rectal cancer. Although the majority of the patients after neoadjuvant therapy are referred to following surgery, the clinical data show that complete clinical or pathological response is found in a significant proportion of the patients. Diagnostic accuracy of confirming the complete response has a crucial role in further management of a rectal cancer patient. As the rate of clinical complete response, unfortunately, is not always consistent with pathological complete response, accurate diagnostic parameters and predictive markers of tumor response may help to guide more personalized treatment strategies and identify potential candidates for nonoperative management more safely. The management of complete response demands interdisciplinary collaboration including oncologists, radiotherapists, radiologists, pathologists, endoscopists and surgeons, because the absence of a multidisciplinary approach may compromise the oncological outcome. Prediction and improvement of rectal cancer response to neoadjuvant therapy is still an active and challenging field of further research. This literature review is summarizing the main, currently known clinical information about the complete response that could be useful in case if encountering such condition in rectal cancer patients after neoadjuvant chemoradiation therapy, using as a source PubMed publications from 2010–2021 matching the search terms “rectal cancer”, “neoadjuvant therapy” and “response”.
Highlights
Rectal cancer represents approximately 35% of the total colorectal cancer incidence [1]
At the moment ISB has several aspects of prognostic usefulness: it provides a strong and independent prognostic factor for disease-free survival (DFS) of patients with rectal cancer; it predicts the response to neoadjuvant chemoradiotherapy (nCRT); ISB combined with imaging post-nCRT discriminates the group of patients with a pathological complete responses (pCR) to nCRT that should benefit from less invasive therapeutic strategies [108]
The difficulties of accurate identification of Complete response (CR) are related to the mismatch of the clinical complete response (cCR) and pCR in a particular proportion of the cases
Summary
Rectal cancer represents approximately 35% of the total colorectal cancer incidence [1] This is a heterogeneous type of cancer that attracts clinical attention due to the variety of treatment options. Patients with pCR after neoadjuvant chemoradiotherapy (nCRT) have improved distant metastatic rates 7–10.5%, when compared to poor responders of NAT—26–31%, respectively [5,6]. The possibility to predict patient’s response to nCRT would help to guide more personalized treatment strategies [1]. This would allow a more precise selection of patients who would benefit the most from nCRT, protect patients from potentially unnecessary treatment, and allow identification of the best candidates for nonoperative management. At present, there are no certain preoperative predictive factors that could determine the response to the NAT and could be implemented into clinical practice so far [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
