In a nutshell
This study investigated the use of different clinical factors in predicting pathological complete response to neoadjuvant chemoradiotherapy among rectal cancer patients.
Some background
Neoadjuvant therapy in rectal cancer refers to treatments given before surgery, such as chemotherapy and/or radiation treatments. Chemoradiation is often used in order to shrink the rectal tumor, thus making surgical resections easier and more likely to succeed. The aim of neoadjuvant therapy is to achieve pathological complete response. Pathological complete response is defined as the absence of any residual cancer cells when the tissue is examined in the lab following surgical removal. Pathological complete response to neoadjuvant treatment is known to significantly extend survival and reduce the risk of cancer recurrence. However, only a small percent of patients treated achieve pathological complete response. This study investigated whether different clinical factors or tumor characteristics could predict which patients will achieve complete response to neoadjuvant therapy.
Methods & findings
This study analyzed the records of 297 rectal cancer patients who underwent neoadjuvant therapy followed by surgical removal of the cancer. Of the 297 patients, 34 (11.4%) achieved pathologic complete response to neoadjuvant treatment.
Analysis showed that limited lymph node involvement most strongly correlated with pathologic complete response. The chances of achieving pathological complete response were found to be 4-times greater among patients without lymph-node involvement (referred to as N0 status), compared to advanced stage patients. Shrinkage of tumor size and a reduction in CEA levels (a protein often produced by colorectal cancer cells) during treatment were also associated with the chance of achieving complete response, but to a lesser extent.
The bottom line
This study concluded that lymph node involvement can predict pathological complete response to neoadjuvant treatments among rectal cancer patients.
Published By :
International Journal of Colorectal Disease
Date :
Jan 14, 2014
