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Predictors of Pathological Complete Response Following Neoadjuvant Chemoradiotherapy for Rectal Cancer.

Journal of Cancer Research and Therapeutics(2022)

Sherikashmir Inst Med Sci | Sohail Univ

Cited 3|Views12
Abstract
Background: Neoadjuvant chemoradiotherapy (NACRT) is an established treatment option for locally advanced rectal cancer (LARC). Patients achieving pathological complete response (pCR) following NACRT have better oncological outcomes and may be subjected to wait and watch policy as well. The aim of this study was to identify predictors of pCR in LARC following NACRT. Materials and Methods: A retrospective analysis of a prospectively maintained colorectal cancer database from January 2018 to December 2019 was undertaken. A total of 129 patients of LARC who were subjected to conventional long course NACRT, followed by surgery were included in the study. Pathological response to NACRT was assessed using Mandard grading system and response was categorized as pCR or not-pCR. Correlation between various clinico pathological parameters and pCR was determined using univariate and multivariate logistic regression analysis. Results: Mean age of patients was 53.79 +/- 1.303 years. Complete pathological response (Mandard Gr 1) was achieved in 24/129 (18.6%) patients. Age of patients more than 60 years ( P = 0.011; odds ratio [OR] 3.194, 95% confidence interval [CI] 1.274-8.011), interval between last dose of NACRT and surgery >8 weeks ( P = 0.004; OR 4.833, 95% CI 1.874-12.467), well-differentiated tumors ( P < 0.0001; OR 32.00, 95% CI 10.14-100.97) and node-negative disease ( P = 0.003; OR 111.0, 95% CI 2.51-48.03) proved to be strong predictors of pCR. Conclusion: Older age, longer interval between NACRT and surgery, node-negative disease and favorable tumor grade help in achieving better pCR rates. Awareness of these variables can be valuable in counseling patients regarding prognosis and treatment options.
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Neoadjuvant chemoradiotherapy,pathological complete response,rectal cancer,tumor regression
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要点】:本研究探讨了新辅助放化疗后局部晚期直肠癌患者达到病理完全缓解(pCR)的预测因子,发现年龄大于60岁、NACRT与手术间隔大于8周、分化良好的肿瘤和淋巴结阴性是pCR的强预测因子。

方法】:通过回顾性分析2018年1月至2019年12月的前瞻性维护的结直肠癌数据库,纳入接受常规长程新辅助放化疗后手术的129例局部晚期直肠癌患者,使用Mandard分级系统评估NACRT的病理反应,并采用单变量和多变量逻辑回归分析确定与pCR相关的临床病理参数。

实验】:本研究未具体描述实验操作过程,使用了2018年1月至2019年12月的前瞻性维护的结直肠癌数据库,未提及具体的数据集名称,分析结果显示年龄、治疗间隔、肿瘤分化和淋巴结状态与pCR相关。