The factors influencing pathological complete response to neoadjuvant concurrent chemoradiotherapy in locally advanced rectal cancer
DU Jinbo
QIU Wenlong
MEI Shiwen
HU Gang
QUAN Jichuan
ZHUANG Meng
WANG Xishan
TANG Jianqiang
Abstract：Objective To explore the factors influencing pathological complete response(pCR)to neoadjuvant concurrent chemoradiotherapy in locally advanced rectal cancer.Methods The clinical data of 226 patients with locally advanced rectal cancer who were admitted to Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College from January 2013 to May 2017 were retrospectively collected.All of the patients received neoadjuvant concurrent chemoradiotherapy and surgery.Multivariate logistic regression was used to analyze the correlation between pCR and clinicopathologic factors such as tumor location,tumor T stage,maximum tumor diameter,extramural vascular invasion(EMVI)and mesorectal fascia(MRF)invasion.The differences in disease-free survival(DFS)and overall sur-vival(OS)were compared between pCR group and non-pCR group.Results The preoperative T stage being T3 stage[OR(95％CI)=3.978(1.227-12.897),P=0.021],the maximum tumor diameter less than 4 cm[OR(95％CI)=2.439(1.046-5.685),P=0.039]and distance from tumor to dentate line less than or equal to 5 cm[OR(95％CI)=3.154(1.229-8.094),P=0.017]were independent influencing factors of obtaining pCR in locally advanced rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy.The 5-year DFS(82.1％vs 67.6％,P=0.046)and OS(87.2％vs 68.5％,P=0.015)in the patients of the pCR group were better than those in the patients of the non-PCR group.Conclusion The rectal cancer patients with preoperative T3 stage,the maximum tumor diameter less than 4 cm and the distance from tumor to dentate line less than or equal to 5 cm can benefit from neoadjuvant concurrent chemo-radiotherapy,and the patients who achieve pCR obtain better prognosis.
Keywords：Rectal cancerNeoadjuvant concurrent chemoradiotherapyPathological complete response(pCR)
Publication Date：2024-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 485-490 )