Clinical factors of post-chemoradiotherapy as valuable indicators for pathological complete response in locally advanced rectal cancer.

Abstract

OBJECTIVES:

Pathological complete response has shown a better prognosis for patients with locally advanced rectal cancer after preoperative chemoradiotherapy. However, correlations between post-chemoradiotherapy clinical factors and pathologic complete response are not well confirmed. The aim of the current study was to identify post-chemoradiotherapy clinical factors that could serve as indicators of pathologic complete response in locally advanced rectal cancer.

METHODS:

This study retrospectively analyzed 544 consecutive patients with locally advanced rectal cancer treated at Sun Yat-sen University Cancer Center from December 2003 to June 2014. All patients received preoperative chemoradiotherapy followed by surgery. Univariate and multivariate regression analyses were performed to identify post-chemoradiotherapy clinical factors that are significant indicators of pathologic complete response.

RESULTS:

In this study, 126 of 544 patients (23.2%) achieved pathological complete response. In multivariate analyses, increased pathological complete response rate was significantly associated with the following factors: post-chemoradiotherapy clinical T stage 0-2 (odds ratio=2.098, 95% confidence interval=1.023-4.304, p=0.043), post-chemoradiotherapy clinical N stage 0 (odds ratio=2.011, 95% confidence interval=1.264-3.201, p=0.003), interval from completion of preoperative chemoradiotherapy to surgery of >7 weeks (odds ratio=1.795, 95% confidence interval=1.151-2.801, p=0.010) and post-chemoradiotherapy carcinoembryonic antigen ≤2 ng/ml (odds ratio=1.579, 95% confidence interval=1.026-2.432, p=0.038).

CONCLUSIONS:

Post-chemoradiotherapy clinical T stage 0-2, post-chemoradiotherapy clinical N stage 0, interval from completion of chemoradiotherapy to surgery of >7 weeks and post-chemoradiotherapy carcinoembryonic antigen ≤2 ng/ml were independent clinical indicators for pathological complete response. These findings demonstrate that post-chemoradiotherapy clinical factors could be valuable for post-operative assessment of pathological complete response.

• Authors: Jianhong Peng, Junzhong Lin, Miaozhen Qiu, Xiaojun Wu, Zhenhai Lu, Gong Chen, Liren Li, Peirong Ding, Yuanhong Gao, Zhifan Zeng, Huizhong Zhang, Desen Wan, Zhizhong Pan
• Journal: Clinics (Sao Paulo, Brazil) (Clinics (Sao Paulo)) Vol. 71 Issue 8 Pg. 449-54 (Aug 2016) ISSN: 1980-5322 [Electronic] United States
• PMID: 27626475 (Publication Type: Journal Article)

Topics

• Adenocarcinoma (pathology, therapy)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy (methods)
• Child
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Neoadjuvant Therapy (methods)
• Neoplasm Staging
• Odds Ratio
• Postoperative Period
• Preoperative Period
• Rectal Neoplasms (pathology, therapy)
• Reference Values
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Young Adult