Predictive Factors of Pathologic Complete Response after Preoperative Chemoradiation in Rectal Cancer

Authors

  • Thitipong Setthalikhit Department of Surgery, Surin Hospital
  • Chairat Supsamutchai Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
  • Chumpon Wilasrusmee Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
  • Tharin Thampongsa Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
  • Jakrapan Jirasiritham Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
  • Jirat Teerapradith Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
  • Pattawia Choikrua Division of General Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University

Keywords:

Pathologic complete response, Preoperative chemoradiation, Locally advanced, Rectal cancer, Predictive factors

Abstract

Background: Some rectal cancer patients may present with locally advanced disease requiring preoperative concurrent chemoradiation (CCRT) before radical surgery. But there is uncertainty as to what constitute predictors for pathologic complete response (pCR) after preoperative CCRT.

Objectives: To identify potential predictors of pCR after preoperative CCRT in rectal cancer.

Materials and Methods: A single-center retrospective cohort study of locally advanced rectal cancer patients who underwent preoperative CCRT followed by radical surgery at a tertiary care hospital between 1 January 2011 and 31 December 2017 was performed. Patients were categorized as having pCR or non-pCR. There were two chemotherapy regimens, 5-fluorouracil-based or Oxaliplatin-based regimens, in the present study. The radiotherapy dose to the pelvis was 50.4 Gy.

Result: A total of 145 patients were included; 25 (17%) patients in the pCR group, 120 (83%) in the non-pCR group. On univariable analysis, pretreatment tumor length less than 5 cm seen on computed tomography (CT) scan (p=0.018) and total harvested lymph nodes less than 12 nodes (p=0.02) were significantly associated with pCR, while initial carcinoembryonic antigen concentration of less than 5.0 ng/dL (p=0.078), clinical stage T2 (p=0.151), and circumferential tumor involvement (p=0.209) were marginally significant. On multivariable analysis, only pretreatment tumor length (p=0.0039), and total lymph nodes harvested (p=0.036) were significantly associated with pCR.

Conclusion: Our study showed that the pretreatment tumor length < 5 cm as seen on CT scan and total lymph nodes harvested < 12 are predictors of pCR after preoperative CCRT in patients with rectal cancer.

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Published

2021-03-30

How to Cite

1.
Setthalikhit T, Supsamutchai C, Wilasrusmee C, Thampongsa T, Jirasiritham J, Teerapradith J, Choikrua P. Predictive Factors of Pathologic Complete Response after Preoperative Chemoradiation in Rectal Cancer. Thai J Surg [Internet]. 2021 Mar. 30 [cited 2024 Apr. 19];42(1):14-22. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/244978

Issue

Vol. 42 No. 1 (2021): January - March

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Original Articles

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