Clinical and Oncological Results of the Pathological Complete Response in Rectal Cancer After Neoadjuvant Treatment

• Published in: Cirugia española (English ed.) Vol. 91; no. 7; pp. 417 - 423
• Main Authors: Codina Cazador, Antonio, Farres Coll, Ramón, Olivet Pujol, Francesc, Martin Grillo, Adam, Pujadas de Palol, Marcel, Gómez Romeu, Nuria, Julia Bergkvist, David, Ortiz Duran, Rosa, Diez Gómez, Ester
• Format: Journal Article
• Language: English
• Published: Elsevier España, S.L.U 01-08-2013
• Subjects: Cáncer de recto; Oncological results; Pathological complete response; Rectal cancer; Respuesta patológica completa; Resultados oncológicos; Surgery; Pathological complete response; Respuesta patológica completa; Oncological results; Rectal cancer; Resultados oncológicos; Cáncer de recto
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2013.11.003

Abstract Introduction Neoadjuvant chemo-radiotherapy is the treatment of choice for rectal cancer in order to reduce local recurrence. Patients with a pathological complete response (PCR) have a better prognosis. The aim of this study was to determine the influence of PCR on the oncological outcomes in our patients. Methods All patients with stage II/III rectal cancer treated with neoadjuvant chemo-radiotherapy and radical resection between 2007 and 2011 were identified from a prospective database, and grouped based on whether they achieved PCR or not (non-PCR). Clinical, histological and oncological outcome data were compared. Results A total of 162 patients were included (62% men), with a mean age of 65 years. In terms of pre-operative TNM staging, 82 patients (50%) were T2, 75 (46%) were T3, and 5 (3%) were T4. Forty-two patients (25%) were N1, and 87 (53%) were N2. Low anterior resection and abdominoperineal resection were performed in 125 (77%) and 25 (15%) patients. Forty-three patients (26.5%) had postoperative morbidity. PCR was achieved in 19 patients (11.7%). After a median follow-up of 26 months, there are no recurrences in the PCR group, and in the non-PCR group, local recurrence was 1.4% ( P =.78), and distant metastasis was 8.4% ( P =.21). Overall survival ( P =.39) and survival free of diseases ( P =.23) were better in the PCR group, but the differences were not significant. Conclusion Patients with pathological complete response have better oncological outcome.