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Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up

Neoadjuvant therapy is the gold standard treatment of locally advanced rectal cancer. It may induce complete sterilization of tumor cell and decreases its local recurrence rate. While 15-20% of patients were found to have pathological complete response (pCR) with combined multimodal therapy, Asian d...

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Main Authors: Leow, Yeen Chin, Roslani, April Camilla, Xavier, Ruben Gregory, Lee, Fei Yee
Format: Article
Published: Springer India 2021
Subjects:
R Medicine
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
RD Surgery
Online Access:http://eprints.um.edu.my/35364/
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spelling my.um.eprints.353642022-10-26T06:25:43Z http://eprints.um.edu.my/35364/ Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up Leow, Yeen Chin Roslani, April Camilla Xavier, Ruben Gregory Lee, Fei Yee R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RD Surgery Neoadjuvant therapy is the gold standard treatment of locally advanced rectal cancer. It may induce complete sterilization of tumor cell and decreases its local recurrence rate. While 15-20% of patients were found to have pathological complete response (pCR) with combined multimodal therapy, Asian data were generally scarce. pCR rate can indicate the suitability of applying the ``watch-and-wait'' strategy, which advocates deferment of surgery that can alleviate surgery-associated morbidity.To determine the percentage of pCR of rectal cancer after neoadjuvant therapy. Patients diagnosed with rectal cancer underwent treatment from 2013 to 2017 were retrieved retrospectively. Demographic data, tumor localization, pre- and post-operative pathological reports, neoadjuvant therapy, and pCR status were collected from patients' records. A total of 242 out of 259 patients were treated with definitive rectal surgery. Mean age was 67.1 years old. Chinese ethnicity and male gender were predominant (n = 131, 54.1% and n = 146, 64.3% respectively). More than half (n = 124, 51.2%) had tumor located at mid or low rectum. Histologically, moderate differentiated adenocarcinoma was predominant (n = 227, 93.8%). Merely half (n = 123, 50.8%) of the patients received neoadjuvant chemoradiation therapy, but only 12 (9.8%) had a pCR. From follow-up on these 12 pCR patients, most had 2-year disease-free survival but 1 (8.3%) of the pCR had distant metastasis within 1-year post-surgery. The pathological complete response rate in our center was lower than reported. Stringent patient selection with close follow-up for patients should be carried out if the ``watch-and-wait'' strategy is implemented in our population. Springer India 2021-08 Article PeerReviewed Leow, Yeen Chin and Roslani, April Camilla and Xavier, Ruben Gregory and Lee, Fei Yee (2021) Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up. Indian Journal Of Surgery, 83 (SUPPL). pp. 768-775. ISSN 0972-2068, DOI https://doi.org/10.1007/s12262-021-02945-5 <https://doi.org/10.1007/s12262-021-02945-5>. 10.1007/s12262-021-02945-5
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
RD Surgery
spellingShingle R Medicine
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
RD Surgery
Leow, Yeen Chin
Roslani, April Camilla
Xavier, Ruben Gregory
Lee, Fei Yee
Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up
description Neoadjuvant therapy is the gold standard treatment of locally advanced rectal cancer. It may induce complete sterilization of tumor cell and decreases its local recurrence rate. While 15-20% of patients were found to have pathological complete response (pCR) with combined multimodal therapy, Asian data were generally scarce. pCR rate can indicate the suitability of applying the ``watch-and-wait'' strategy, which advocates deferment of surgery that can alleviate surgery-associated morbidity.To determine the percentage of pCR of rectal cancer after neoadjuvant therapy. Patients diagnosed with rectal cancer underwent treatment from 2013 to 2017 were retrieved retrospectively. Demographic data, tumor localization, pre- and post-operative pathological reports, neoadjuvant therapy, and pCR status were collected from patients' records. A total of 242 out of 259 patients were treated with definitive rectal surgery. Mean age was 67.1 years old. Chinese ethnicity and male gender were predominant (n = 131, 54.1% and n = 146, 64.3% respectively). More than half (n = 124, 51.2%) had tumor located at mid or low rectum. Histologically, moderate differentiated adenocarcinoma was predominant (n = 227, 93.8%). Merely half (n = 123, 50.8%) of the patients received neoadjuvant chemoradiation therapy, but only 12 (9.8%) had a pCR. From follow-up on these 12 pCR patients, most had 2-year disease-free survival but 1 (8.3%) of the pCR had distant metastasis within 1-year post-surgery. The pathological complete response rate in our center was lower than reported. Stringent patient selection with close follow-up for patients should be carried out if the ``watch-and-wait'' strategy is implemented in our population.
format Article
author Leow, Yeen Chin
Roslani, April Camilla
Xavier, Ruben Gregory
Lee, Fei Yee
author_facet Leow, Yeen Chin
Roslani, April Camilla
Xavier, Ruben Gregory
Lee, Fei Yee
author_sort Leow, Yeen Chin
title Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up
title_short Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up
title_full Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up
title_fullStr Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up
title_full_unstemmed Pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: A 5-year follow-up
title_sort pathological complete response after neoadjuvant therapy in rectal adenocarcinoma: a 5-year follow-up
publisher Springer India
publishDate 2021
url http://eprints.um.edu.my/35364/
_version_ 1748181081709871104
score 13.211869

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