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Can we predict pathologic complete response before surgery for locally advanced rectal cancer treated with preoperative chemoradiation therapy?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Pathologic complete response has been proven to have oncological benefits for locally advanced rectal cancer treated with chemoradiation therapy. The aims of this study are to analyze and determine the factors to predict pathologic complete response for patients treated with preoperative neoadjuvant therapy.

Methods

Patients with biopsy-proven, locally advanced rectal cancer were treated neoadjuvantly followed by radical surgical resection. Tumors were re-assessed after completing chemoradiation, including pelvic magnetic resonance images, colonoscopic examination, and re-biopsy. The results of examination were compared with the final pathologic status.

Results

A retrospective chart review of 166 patients was conducted. Twenty-five patients (15.1%) had pathologic complete response after chemoradiation. The 5-year overall survival rates were better in the complete response group than the residual tumor group (91.1% vs. 70.8%; P = 0.047), and there were also significant differences in the 5-year disease-free survival rates between these two groups (91.1% vs. 70.2%; P = 0.027). The prediction rates for pathologic complete response by re-biopsy, magnetic resonance images, and colonoscopy were 21.4%, 33.3%, and 53.8%, respectively. In addition, when we further combine the results of colonoscopic findings and re-biopsy, the prediction rate for pathologic complete response reached 77.8% (P = 0.009).

Conclusions

Combining the results of the re-biopsy and post-treatment colonoscopic findings, we can achieve a good prediction rate for pathologic complete response. Post-treatment magnetic resonance images are not useful tools in predicting tumor clearance following chemoradiation.

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Acknowledgments

This work was supported by Taipei Medical University and Hospital Grant (100TMU-TMUH-02).

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Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Li-Jen Kuo, Chin-Sheng Hung, Ka-Wai Tam, Yu-Jia Chang & Po-Li Wei

  2. Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, 252 Wuxing Street, Sinyi District, Taipei, 11031, Taiwan

    Li-Jen Kuo, Chin-Sheng Hung, Weu Wang, Ka-Wai Tam, Hung-Chia Lee, Hung-Hua Liang & Po-Li Wei

  3. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Sinyi District, Taipei, 11031, Taiwan

    Li-Jen Kuo, Chin-Sheng Hung, Weu Wang, Ka-Wai Tam, Hung-Hua Liang, Yu-Jia Chang & Po-Li Wei

  4. Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan

    Jeng-Fong Chiou

  5. Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan

    Cheng-Jeng Tai

  6. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan

    Chun-Chao Chang

  7. Department of Diagnostic Radiology, Taipei Medical University Hospital, Taipei, Taiwan

    Ching-Huei Kung

  8. Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan

    Sey-En Lin

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  1. Li-Jen Kuo
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Correspondence to Yu-Jia Chang or Po-Li Wei.

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Kuo, LJ., Chiou, JF., Tai, CJ. et al. Can we predict pathologic complete response before surgery for locally advanced rectal cancer treated with preoperative chemoradiation therapy?. Int J Colorectal Dis 27, 613–621 (2012). https://doi.org/10.1007/s00384-011-1348-8

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  • DOI: https://doi.org/10.1007/s00384-011-1348-8

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