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Histopathological, Radiological, and Demographic Factors Predicting the Response to Neoadjuvant Therapy for Rectal Cancer

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Abstract

Background/Aim

While the treatment for early stage rectal cancer is surgery, when a diagnosis is made at a locally advanced stage, it is recommended to start treatment with neoadjuvant chemoradiotherapy. Therefore, it is important to determine which patients will respond best to neoadjuvant treatment. The aim of this study was to investigate which hematological, histopathological, and radiological parameters can predict the response to chemoradiotherapy.

Methods and Material

A retrospective examination was made of 43 patients who underwent surgery following neoadjuvant chemoradiotherapy because of locally advanced stage rectal cancer. Demographic data were collected from the patient files, and the radiological, histopathological, and laboratory findings before neoadjuvant chemoradiotherapy were compared with the findings after treatment.

Results

In the postoperative evaluation, a pathological complete response was determined in 25.50% of the patients. Lymphovascular invasion, perineural invasion, and absence of necrosisis were seen to be statistically related to major response (p < 0.05), and in patients where the tumor was closer than 6 cm to the anal verge, the response was better

Conclusion

When the findings were examined, histopathological lymphovascular invasion, perineural invasion, the presence of necrosis, and the anal verge distance were evaluated as parameters predicting the response to neoadjuvant chemoradiotherapy in rectal cancer.

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Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Authors and Affiliations

  1. Department of General Surgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey

    Emine Yildirim, Zekeriya Pelen & Ahmet Muzaffer Er

  2. Department of Pathology, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey

    Sibel Bektas & Irem Yanik

  3. Department of Radiology, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey

    Ferhat Cengel

  4. Department of İnternal Medicine, University of Health Sciences Turkey, Cemil Tascioglu City Hospital, Prof. Dr, Istanbul, Turkey

    Perihan Özkan Gumuskaya

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  1. Emine Yildirim
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Contributions

EY, AME, IY, and ZP performed the literature search, database set up and contributed to the writing of the manuscript. EY and SB reviewed the manuscript. POG and FC contributed to the study design and reviewed the manuscript. EY, SB, and ZP contributed to the study design, the writing of the manuscript and reviewed the manuscript. All authors are in agreement will all aspects of the final manuscript.

Corresponding author

Correspondence to Emine Yildirim.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval for this study was granted from XXXX Hospital Ethics Committee for Clinical Studies in July 2020 (reg:83).

Informed Consent

Informed consent was not required due to the retrospective use of de-identifed administrative data.

Conflict of Interest

The authors declare no competing interests.

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Yildirim, E., Bektas, S., Pelen, Z. et al. Histopathological, Radiological, and Demographic Factors Predicting the Response to Neoadjuvant Therapy for Rectal Cancer. J Gastrointest Canc 53, 22–30 (2022). https://doi.org/10.1007/s12029-021-00697-9

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