Andrew J Geiser1, Supriya Patel, MD2, Ina Zamfirova, MS1, Jeremy Sugrue, MD3, Slawomir Marecik, MD2, John Park, MD2. 1James R. & Helen D. Russell Institute for Research & Innovation, Advocate Lutheran General Hospital, Park Ridge, Illinois, 2Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois, 3Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, Illinois
Introduction: Some patients who undergo neoadjuvant chemoradiation therapy (CRT) for rectal cancer achieve a pathologic complete response (pCR) in which no tumor cells are discovered during pathologic analysis of the resection specimen. Achievement of pCR is correlated to improved prognoses relative to non-pCR counterparts. Such correlations are not well established in the context of a community-based hospital. The study sought to examine response rates, recurrences, and survivals in locally advanced rectal cancer patients and compare patient outcomes to those achieved at major academic institutions.
Methods and Procedures: A single-center retrospective chart review was performed at a local, community-based hospital. Study population consisted of 118 patients with locally advanced rectal cancer treated with neoadjuvant CRT followed by surgical resection. Patients with a history of metastasis, Inflammatory Bowel Disease (IBD), hereditary cancer syndromes, concurrent or prior malignancy, and emergent surgery were excluded.
Results: 24 patients (20.3%) achieved pCR in the test population. Across both groups, mean age (p=.352), gender (p=.254), and ethnicity (p=.529) were found to be comparable. Mean interval between CRT and OR (p=.116), pre-op stage (p=.736), number of nodes (p=.208), radiation dose (p=.094), tumor location (p=.753), and days of follow-up (p=.497) presented statistically insignificant differences between groups. At 5 years, 26 non-pCR patients (27.7%) had a recurrence with zero recurrences in the pCR group. 5-year mortality presented 25 non-pCR patients (26.6%) compared to 1 pCR patient (4.17%).
Conclusion: A multidisciplinary approach to rectal cancer consisting of standardized preoperative treatment and surgical resection can achieve patient outcomes and survival similar to those of larger academic institutions, even in the context of a community-based hospital.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88490
Program Number: P287
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster