Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer

Background: Neoadjuvant chemoradiotherapy prior to surgery is the standard treatment for locally advanced rectal cancer. This consists in the patient’s complete pathological response being achieved with no residual tumor presence in the resected specimen, which results in survival improvement. Metho...

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Main Authors: Cemal Ulusoy, Gülçin Harman Kamalı, Andrej Nikolovski
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Current Oncology
Subjects:
Online Access:https://www.mdpi.com/1718-7729/30/1/81
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author Cemal Ulusoy
Gülçin Harman Kamalı
Andrej Nikolovski
author_facet Cemal Ulusoy
Gülçin Harman Kamalı
Andrej Nikolovski
author_sort Cemal Ulusoy
collection DOAJ
description Background: Neoadjuvant chemoradiotherapy prior to surgery is the standard treatment for locally advanced rectal cancer. This consists in the patient’s complete pathological response being achieved with no residual tumor presence in the resected specimen, which results in survival improvement. Methods: This retrospective study aimed to examine the rate of complete pathological response in patients with advanced rectal cancer treated with neoadjuvant long-course chemoradiotherapy and to examine the survival differences between the different tumor regression grade (TRG) scores. Results: A total of 154 patients were operated prior to long-course chemoradiotherapy with a total of 50 Gy plus FOLFOX protocol. Complete pathologic response was achieved in 29 (18.8%) patients. There was no statistical difference for the different pathologic responses according to gender, type of surgery, and number of harvested lymph nodes. Mean survival for all the groups was 37.2 months. Survival within a different TRG score exhibited statistical significance (<i>p</i> = 0.006). Overall, the survival rate during the follow-up period was of 81.8%. Conclusions: The complete pathological response rate in this study was of 18.8%. High tumor regression grade scores (TRG0 and TRG1) had a survival rate of over 90% during follow-up. Multivariate analysis identified perineural invasion and tumor regression grade as independent factors that affect survival.
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spelling doaj.art-1b1073550f934655ad7218dad53cc36b2023-11-30T21:50:00ZengMDPI AGCurrent Oncology1198-00521718-77292023-01-013011054106410.3390/curroncol30010081Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal CancerCemal Ulusoy0Gülçin Harman Kamalı1Andrej Nikolovski2Department of General Surgery, Prof. Dr. Cemil Taşçıoğlu Şehir Hastanesi, Istanbul 34384, TurkeyDepartment of Pathology, Prof. Dr. Cemil Taşçıoğlu Şehir Hastanesi, Istanbul 34384, TurkeyDepartment of Visceral Surgery, University Surgical Clinic “Sv. Naum Ohridski”, Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North MacedoniaBackground: Neoadjuvant chemoradiotherapy prior to surgery is the standard treatment for locally advanced rectal cancer. This consists in the patient’s complete pathological response being achieved with no residual tumor presence in the resected specimen, which results in survival improvement. Methods: This retrospective study aimed to examine the rate of complete pathological response in patients with advanced rectal cancer treated with neoadjuvant long-course chemoradiotherapy and to examine the survival differences between the different tumor regression grade (TRG) scores. Results: A total of 154 patients were operated prior to long-course chemoradiotherapy with a total of 50 Gy plus FOLFOX protocol. Complete pathologic response was achieved in 29 (18.8%) patients. There was no statistical difference for the different pathologic responses according to gender, type of surgery, and number of harvested lymph nodes. Mean survival for all the groups was 37.2 months. Survival within a different TRG score exhibited statistical significance (<i>p</i> = 0.006). Overall, the survival rate during the follow-up period was of 81.8%. Conclusions: The complete pathological response rate in this study was of 18.8%. High tumor regression grade scores (TRG0 and TRG1) had a survival rate of over 90% during follow-up. Multivariate analysis identified perineural invasion and tumor regression grade as independent factors that affect survival.https://www.mdpi.com/1718-7729/30/1/81complete pathological responseneoadjuvant chemoradiotherapyrectal cancersurvivaltumor regression grade
spellingShingle Cemal Ulusoy
Gülçin Harman Kamalı
Andrej Nikolovski
Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
Current Oncology
complete pathological response
neoadjuvant chemoradiotherapy
rectal cancer
survival
tumor regression grade
title Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
title_full Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
title_fullStr Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
title_full_unstemmed Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
title_short Analysis of Survival in Complete Pathological Response after Long-Course Chemoradiotherapy in Patients with Advanced Rectal Cancer
title_sort analysis of survival in complete pathological response after long course chemoradiotherapy in patients with advanced rectal cancer
topic complete pathological response
neoadjuvant chemoradiotherapy
rectal cancer
survival
tumor regression grade
url https://www.mdpi.com/1718-7729/30/1/81
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AT gulcinharmankamalı analysisofsurvivalincompletepathologicalresponseafterlongcoursechemoradiotherapyinpatientswithadvancedrectalcancer
AT andrejnikolovski analysisofsurvivalincompletepathologicalresponseafterlongcoursechemoradiotherapyinpatientswithadvancedrectalcancer