Abstract

Background Pathologic complete response has been proven to have oncological benefits for locally advanced rectal cancer treated with chemoradiation therapy. The aims of this study are to analyze and determine the factors to predict pathologic complete response for patients treated with preoperative neoadjuvant therapy. Methods Patients with biopsy-proven, locally advanced rectal cancer were treated neoadjuvantly followed by radical surgical resection. Tumors were re-assessed after completing chemoradiation, including pelvic magnetic resonance images, colonoscopic examination, and re-biopsy. The results of examination were compared with the final pathologic status. Results A retrospective chart review of 166 patients was conducted. Twenty-five patients (15.1%) had pathologic complete response after chemoradiation. The 5-year overall survival rates were better in the complete response group than the residual tumor group (91.1% vs. 70.8%; P=0.047), and there were also significant differences in the 5-year disease-free survival rates between these two groups (91.1% vs. 70.2%; P=0.027). The prediction rates for pathologic complete response by re-biopsy, magnetic resonance images, and colonoscopy were 21.4%, 33.3%, and 53.8%, respectively. In addition, when we further combine the results of colonoscopic findings and re-biopsy, the prediction rate for pathologic complete response reached 77.8% (P=0.009). Conclusions Combining the results of the re-biopsy and post-treatment colonoscopic findings, we can achieve a good prediction rate for pathologic complete response. Posttreatment magnetic resonance images are not useful tools in predicting tumor clearance following chemoradiation.

Original languageEnglish
Pages (from-to)613-621
Number of pages9
JournalInternational Journal of Colorectal Disease
Volume27
Issue number5
DOIs
Publication statusPublished - May 2012

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Rectal Neoplasms
Biopsy
Magnetic Resonance Spectroscopy
Survival Rate
Therapeutics
Neoadjuvant Therapy
Residual Neoplasm
Colonoscopy
Statistical Factor Analysis
Disease-Free Survival
Neoplasms

Keywords

  • Chemoradiation
  • Colonoscopy
  • Complete pathologic response
  • Magnetic resonance images
  • Neoadjuvant therapy
  • Rectal cancer

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{0ebe4ab550314ad3bc6023d3bbbd733a,
title = "Can we predict pathologic complete response before surgery for locally advanced rectal cancer treated with preoperative chemoradiation therapy?",
abstract = "Background Pathologic complete response has been proven to have oncological benefits for locally advanced rectal cancer treated with chemoradiation therapy. The aims of this study are to analyze and determine the factors to predict pathologic complete response for patients treated with preoperative neoadjuvant therapy. Methods Patients with biopsy-proven, locally advanced rectal cancer were treated neoadjuvantly followed by radical surgical resection. Tumors were re-assessed after completing chemoradiation, including pelvic magnetic resonance images, colonoscopic examination, and re-biopsy. The results of examination were compared with the final pathologic status. Results A retrospective chart review of 166 patients was conducted. Twenty-five patients (15.1{\%}) had pathologic complete response after chemoradiation. The 5-year overall survival rates were better in the complete response group than the residual tumor group (91.1{\%} vs. 70.8{\%}; P=0.047), and there were also significant differences in the 5-year disease-free survival rates between these two groups (91.1{\%} vs. 70.2{\%}; P=0.027). The prediction rates for pathologic complete response by re-biopsy, magnetic resonance images, and colonoscopy were 21.4{\%}, 33.3{\%}, and 53.8{\%}, respectively. In addition, when we further combine the results of colonoscopic findings and re-biopsy, the prediction rate for pathologic complete response reached 77.8{\%} (P=0.009). Conclusions Combining the results of the re-biopsy and post-treatment colonoscopic findings, we can achieve a good prediction rate for pathologic complete response. Posttreatment magnetic resonance images are not useful tools in predicting tumor clearance following chemoradiation.",
keywords = "Chemoradiation, Colonoscopy, Complete pathologic response, Magnetic resonance images, Neoadjuvant therapy, Rectal cancer",
author = "Li-Jen Kuo and Jeng-Fong Chiou and Cheng-Jeng Tai and Chun-Chao Chang and Kung, {Ching Huei} and Lin, {Sey En} and Chin-Sheng Hung and Weu Wang and Ka-Wai Tam and Lee, {Hung Chia} and Hung-Hua Liang and Yu-Jia Chang and Po-Li Wei",
year = "2012",
month = "5",
doi = "10.1007/s00384-011-1348-8",
language = "English",
volume = "27",
pages = "613--621",
journal = "International Journal of Colorectal Disease",
issn = "0179-1958",
publisher = "Springer Verlag",
number = "5",

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TY - JOUR

T1 - Can we predict pathologic complete response before surgery for locally advanced rectal cancer treated with preoperative chemoradiation therapy?

AU - Kuo, Li-Jen

AU - Chiou, Jeng-Fong

AU - Tai, Cheng-Jeng

AU - Chang, Chun-Chao

AU - Kung, Ching Huei

AU - Lin, Sey En

AU - Hung, Chin-Sheng

AU - Wang, Weu

AU - Tam, Ka-Wai

AU - Lee, Hung Chia

AU - Liang, Hung-Hua

AU - Chang, Yu-Jia

AU - Wei, Po-Li

PY - 2012/5

Y1 - 2012/5

N2 - Background Pathologic complete response has been proven to have oncological benefits for locally advanced rectal cancer treated with chemoradiation therapy. The aims of this study are to analyze and determine the factors to predict pathologic complete response for patients treated with preoperative neoadjuvant therapy. Methods Patients with biopsy-proven, locally advanced rectal cancer were treated neoadjuvantly followed by radical surgical resection. Tumors were re-assessed after completing chemoradiation, including pelvic magnetic resonance images, colonoscopic examination, and re-biopsy. The results of examination were compared with the final pathologic status. Results A retrospective chart review of 166 patients was conducted. Twenty-five patients (15.1%) had pathologic complete response after chemoradiation. The 5-year overall survival rates were better in the complete response group than the residual tumor group (91.1% vs. 70.8%; P=0.047), and there were also significant differences in the 5-year disease-free survival rates between these two groups (91.1% vs. 70.2%; P=0.027). The prediction rates for pathologic complete response by re-biopsy, magnetic resonance images, and colonoscopy were 21.4%, 33.3%, and 53.8%, respectively. In addition, when we further combine the results of colonoscopic findings and re-biopsy, the prediction rate for pathologic complete response reached 77.8% (P=0.009). Conclusions Combining the results of the re-biopsy and post-treatment colonoscopic findings, we can achieve a good prediction rate for pathologic complete response. Posttreatment magnetic resonance images are not useful tools in predicting tumor clearance following chemoradiation.

AB - Background Pathologic complete response has been proven to have oncological benefits for locally advanced rectal cancer treated with chemoradiation therapy. The aims of this study are to analyze and determine the factors to predict pathologic complete response for patients treated with preoperative neoadjuvant therapy. Methods Patients with biopsy-proven, locally advanced rectal cancer were treated neoadjuvantly followed by radical surgical resection. Tumors were re-assessed after completing chemoradiation, including pelvic magnetic resonance images, colonoscopic examination, and re-biopsy. The results of examination were compared with the final pathologic status. Results A retrospective chart review of 166 patients was conducted. Twenty-five patients (15.1%) had pathologic complete response after chemoradiation. The 5-year overall survival rates were better in the complete response group than the residual tumor group (91.1% vs. 70.8%; P=0.047), and there were also significant differences in the 5-year disease-free survival rates between these two groups (91.1% vs. 70.2%; P=0.027). The prediction rates for pathologic complete response by re-biopsy, magnetic resonance images, and colonoscopy were 21.4%, 33.3%, and 53.8%, respectively. In addition, when we further combine the results of colonoscopic findings and re-biopsy, the prediction rate for pathologic complete response reached 77.8% (P=0.009). Conclusions Combining the results of the re-biopsy and post-treatment colonoscopic findings, we can achieve a good prediction rate for pathologic complete response. Posttreatment magnetic resonance images are not useful tools in predicting tumor clearance following chemoradiation.

KW - Chemoradiation

KW - Colonoscopy

KW - Complete pathologic response

KW - Magnetic resonance images

KW - Neoadjuvant therapy

KW - Rectal cancer

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U2 - 10.1007/s00384-011-1348-8

DO - 10.1007/s00384-011-1348-8

M3 - Article

VL - 27

SP - 613

EP - 621

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

SN - 0179-1958

IS - 5

ER -