Predictive value of clinical factors for pathological complete response following neoadjuvant chemoradiotherapy in locally advanced colorectal cancer patients
JIANG Die
HAN Xiumei
TAO Jie
WANG Ruipeng
ZHU Chaomang
LI Duojie
YIN Hongmei
Abstract：Objective To investigate the clinical factors influencing pathological complete response(pCR)after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer(LARC).Methods A retrospective analysis was conducted on the clinical data of 122 LARC patients admitted to the First Affiliated Hospital of Bengbu Medical University from January 2017 to June 2023.Univariate analysis and binary logistic multivariate regression analysis were used to examine the clinical factors affecting pCR,while ROC curve analysis was further employed to validate the predictive accuracy of certain indicators for pCR.Results Among the 122 enrolled patients,27(22.13%)achieved pCR.Univariate analysis revealed that extramural venous invasion(EMVI),pretreatment carcinoembryonic antigen(CEA)level,perineural invasion,lymphovascular invasion,circumferential tumor extent,and tumor length were statistically correlated with pCR.The Hosmer-Lemeshow test showed a goodness-of-fit significance of 0.168.ROC curve analysis of MRI-measured tumor length yielded an AUC of 0.706,with a sensitivity of 85.3%and specificity of 59.3%,and the optimal cutoff value was 1.65 cm.For CEA in predicting pCR,the AUC was 0.632,with a sensitivity of 42.1%and specificity of 88.9%,and the optimal cutoff value was 4.955 ng/mL.Multivariate analysis identified lymphovascular invasion,circumferential tumor extent,and tumor longitudinal length as independent predictors of pCR.Conclusion Lymphovascular invasion,circumferential tumor extent,and tumor length may be critical determinants for achieving pCR after neoadjuvant chemoradiotherapy in LARC patients.
Keywords：locally advanced colorectal cancerneoadjuvant therapypathological complete remissiontumor regression gradecarcinoembryonic antigenlevel
Publication Date：2025-06-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 711-718 )