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Pathological Predictors of Response to Neoadjuvant Treatment in Rectal Carcinoma

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Abstract

Purpose

Neoadjuvant chemoradiotherapy has now become a standard treatment for rectal cancer. Recently, attempts have been made to predict the response rate to this treatment to decide whether or not it must be performed. However, tissue factors for predicting the response rate is not cohesively reviewed.

Methods

Eighty-three patients with rectal cancer, all under neoadjuvant chemoradiotherapy and subsequent surgery, were examined for tissue factors in the biopsy sample. The tissue factors examined include tumor differentiation grade, lymphovascular invasion, perineural invasion, pathological stage, and lymphocytic infiltration. Lymphocytic infiltration was investigated by immunohistochemistry for CD8 T lymphocyte in biopsy samples.

Results

In this study, tissue factors were found to play a decisive role in predicting response to neoadjuvant treatment. The most important factor was the pathological stage, which has the highest correlation with response to treatment. There is a significant relationship between CD8 lymphocyte infiltration and response to treatment (P value = 0.018). Primary perineural invasion and lymphovascular invasion also have a significant meaningful relationship with response to treatment (P value = 0.021 and P value = 0.036).

Conclusion

In this study, it was determined that the investigated factors have a significant relationship with response to treatment and could be used to predict the response to treatment, and if a low possibility of positive response exists, prevention of the complications of neoadjuvant chemoradiotherapy for the patients could occur.

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Data Availability

Data will be available on request.

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Acknowledgments

We acknowledge the work of Dr. Mohamadreza Rouhi in collecting patients’ data.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mona Malekzadeh Moghani

  2. Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Sam Alahyari

  3. Department of Pathology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Afshin Moradi

  4. Department of Biostatics, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Malihe Nasiri

Authors
  1. Mona Malekzadeh Moghani
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  2. Sam Alahyari
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  3. Afshin Moradi
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  4. Malihe Nasiri
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Contributions

Mona Malekzadeh Moghani: Conceptualization, methodology, validation, resources, writing (review and editing), supervision, project administration. Sam Alahyari: Conceptualization, methodology, software, investigation, writing (original draft). Afshin Moradi: Methodology, validation, investigation, writing (review and editing), resources, supervision. Malihe Nasiri: Software, validation, formal analysis.

Corresponding author

Correspondence to Sam Alahyari.

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The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of Shahid Beheshti University of Medical Sciences research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Malekzadeh Moghani, M., Alahyari, S., Moradi, A. et al. Pathological Predictors of Response to Neoadjuvant Treatment in Rectal Carcinoma. J Gastrointest Canc 52, 690–695 (2021). https://doi.org/10.1007/s12029-020-00450-8

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  • DOI: https://doi.org/10.1007/s12029-020-00450-8

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