Mehmet Ilhan, Ali Fuat Kaan Gök, Seyma Karakus, Ercin Sönmez, Hakan Yanar, Kayihan Günay, Recep Güloglu, Cemalettin Ertekin. Department of General Surgery, Istanbul University Istanbul Medical Faculty
OBJECTIVE: Downstaging and pathologic complete response (pCR) after chemoradiotherapy (CRT) may improve progression-free survival and overall survival (OS) after curative therapy of of rectum. The purpose of this study is to evaluate the pathologic response subsequent to neoadjuvant chemoradiation in locally advanced rectal adenocarcinoma and any impact of response on oncological outcome.
METHODS: We retrospectively assessed the clinical outcomes of 76 histologically-proven rectal adenocarcinoma were treated with preoperative radiotherapy and concurrent 5-fluorouracil (5 FU), and followed by curative surgery in Department of Surgery, Istanbul University School of Medicine between January 2010 and March 2016. Pathologic response to neoadjuvant treatment was evaluated by comparing pathologic tumour and nodal staging with pre-treatment clinical staging. Disease-free survival (DFS) and OS were compared in patients with: pathologic complete response, partial pathologic response and no response toneoadjuvant therapy.
RESULTS: 17,1 % (13 patients) had a pathologic complete response and 82,9 % (63) showed downstaging. At follow-up range, 72-6 months, 11,8 % (9) showed recurrence: 14,5 % (11) distant metastasis, 7,7% (1) of the patients with pathologic complete response showed distant metastasis, one showed local recurrence. In the downstaged group, 8 had local recurrence (12,7 % ). Patients with pathologic complete response showed 84,6 % DFS and 84,6 % OS. In partial responders, DFS was 65 % and OS was 76 %. Patients with pCR had a significantly greater probability of DFS and OS than In partial responders. Rectal cancer-related death was 22,4 % (17) patient 2 % with pCR and 2,6 % in 19,8 % the downstaged group
CONCLUSIONS: The majority of patients showed some response to neoadjuvant treatment. Findings of this study indicate tumour response to neoadjuvant chemoradiotherapy improves the long-term outcome, with a better result in patients with pathologic complete response.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77728
Program Number: P257
Presentation Session: Poster (Non CME)
Presentation Type: Poster
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