Re-evaluation of the tumor is beneficial for treatment planning in advanced rectal cancer patients

This study investigated the necessity of re-evaluation of locally advanced tumors (spread to the lymph nodes) after chemotherapy and radiation therapy. Researchers reported that re-evaluation is important to better plan treatment. 

Chemotherapy and radiation therapy (CTRT) followed by surgery is the standard procedure for locally advanced rectal cancer. Magnetic resonance imaging (MRI) to determine the stage of the tumor and computed tomography (CT) to detect possible metastasis (spread to other parts of the body) are important for the initial accurate diagnosis. However, not all patients who undergo CTRT progress to a successful surgery. A significant number of these patients experience progression of the disease.

There is no clear evidence for the necessity of CT after CTRT to determine the existence of metastasis to better plan the treatment/surgery.

The objective of this study was to identify the factors for a higher risk of disease progression between CTRT and surgery. This study included 115 patients whose tumors were defined as low and high grade tumors depending on how advanced the disease was. These patients underwent CTRT and were re-evaluated after.

62.6% went on to surgery, while 11.3% developed disease progression and 13% developed metastatic disease. 32.1% of those with high-grade tumors experienced disease progression, compared to 5.6% of those with low-grade tumors. 35.7% of those with high-grade tumors experienced metastasis compared to 6.9% of those with low-grade tumors.

This study determined that re-evaluating the high-grade tumors after CTRT would help to better plan treatment.