Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years
Background: With the advances of neoadjuvant chemoradiotherapy, the identification of complete tumor responses, and the reduction of local recurrence even with the adoption of expectant approaches aimed at sphincter preservation, several authors have published results analyzing these aspects with co...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Shiraz University of Medical Sciences
2020-09-01
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| Series: | Iranian Journal of Colorectal Research |
| Subjects: | |
| Online Access: | https://colorectalresearch.sums.ac.ir/article_46989_1b208e42066db886eb37ce9a420fba4a.pdf |
| _version_ | 1811181677823655936 |
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| author | Humberto Lyra Junior Luiz Henrique Minatti João Carlos de Oliveira Marlus Gerber Flavia de Novaes Gerber Daniella Vieira José Mauro dos Santos |
| author_facet | Humberto Lyra Junior Luiz Henrique Minatti João Carlos de Oliveira Marlus Gerber Flavia de Novaes Gerber Daniella Vieira José Mauro dos Santos |
| author_sort | Humberto Lyra Junior |
| collection | DOAJ |
| description | Background: With the advances of neoadjuvant chemoradiotherapy, the identification of complete tumor responses, and the reduction of local recurrence even with the adoption of expectant approaches aimed at sphincter preservation, several authors have published results analyzing these aspects with conflicting results, which require further investigation. Objectives: This study aims to evaluate the anatomopathological changes in surgical specimens of rectal resection due to adenocarcinoma in patients undergoing neoadjuvant therapy, including the complete response rate, in addition to estimating the sensitivity and specificity indexes of the imaging methods used in the preoperative period. Methods: This was an observational, retrospective, cross-sectional study in which 44 medical records of patients with cancer of the middle and lower rectum who underwent neoadjuvant chemoradiotherapy and subsequently underwent oncological surgical resections over 10 years were studied. Demographic data, CT scans, colonoscopies, anatomopathological reports and surgical reports were analyzed. Results: Abdominoperineal resection of the rectum (APR) was performed in 16 cases (36.4%), and abdominal rectosigmoidectomy (AR) was performed in 28 cases (63.6%). Preoperative computerized tomography (CT) showed a sensitivity of 75% and specificity of 77.8% for the detection of lymph node metastases. The complete pathological response to neoadjuvant chemoradiotherapy was found in 11.36% of cases. The local recurrence was detected in 23.9% cases and distant metastasis in 15.2% of the patients on the follow-up period, additionally, there was a 77.7% 5-years disease-free survival and the overall survival was 73.9%. Conclusions: The rate of complete pathological response to neoadjuvant therapy was 11.36%. Locally advanced disease and angiolymphatic embolization were associated with a higher frequency of lymph node involvement. CT obtained high rates of sensitivity and specificity for comparison with anatomopathological results. |
| first_indexed | 2024-04-11T09:21:36Z |
| format | Article |
| id | doaj.art-877592d6d05340d1949f48e86f008930 |
| institution | Directory Open Access Journal |
| issn | 2783-2430 |
| language | English |
| last_indexed | 2024-04-11T09:21:36Z |
| publishDate | 2020-09-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Colorectal Research |
| spelling | doaj.art-877592d6d05340d1949f48e86f0089302022-12-22T04:32:10ZengShiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24302020-09-018314114710.30476/acrr.2020.87993.106346989Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 YearsHumberto Lyra Junior0Luiz Henrique Minatti1João Carlos de Oliveira2Marlus Gerber3Flavia de Novaes Gerber4Daniella Vieira5José Mauro dos Santos6Department of Surgery, Colon and Rectal Surgeon of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, BrazilGraduate student, Medicine Course, Federal University of Santa Catarina, Florianopolis-SC, BrazilDepartment of Surgery, Colon and Rectal Surgeon of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, BrazilColon and Rectal Surgeon of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, BrazilPathologist of Universitary Hospital of Federal University of Santa CatarinaDepartment of Pathology of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, BrazilDepartment of Surgery, Colon and Rectal Surgeon of Universitary Hospital of Federal University of Santa Catarina, Florianopolis-SC, BrazilBackground: With the advances of neoadjuvant chemoradiotherapy, the identification of complete tumor responses, and the reduction of local recurrence even with the adoption of expectant approaches aimed at sphincter preservation, several authors have published results analyzing these aspects with conflicting results, which require further investigation. Objectives: This study aims to evaluate the anatomopathological changes in surgical specimens of rectal resection due to adenocarcinoma in patients undergoing neoadjuvant therapy, including the complete response rate, in addition to estimating the sensitivity and specificity indexes of the imaging methods used in the preoperative period. Methods: This was an observational, retrospective, cross-sectional study in which 44 medical records of patients with cancer of the middle and lower rectum who underwent neoadjuvant chemoradiotherapy and subsequently underwent oncological surgical resections over 10 years were studied. Demographic data, CT scans, colonoscopies, anatomopathological reports and surgical reports were analyzed. Results: Abdominoperineal resection of the rectum (APR) was performed in 16 cases (36.4%), and abdominal rectosigmoidectomy (AR) was performed in 28 cases (63.6%). Preoperative computerized tomography (CT) showed a sensitivity of 75% and specificity of 77.8% for the detection of lymph node metastases. The complete pathological response to neoadjuvant chemoradiotherapy was found in 11.36% of cases. The local recurrence was detected in 23.9% cases and distant metastasis in 15.2% of the patients on the follow-up period, additionally, there was a 77.7% 5-years disease-free survival and the overall survival was 73.9%. Conclusions: The rate of complete pathological response to neoadjuvant therapy was 11.36%. Locally advanced disease and angiolymphatic embolization were associated with a higher frequency of lymph node involvement. CT obtained high rates of sensitivity and specificity for comparison with anatomopathological results.https://colorectalresearch.sums.ac.ir/article_46989_1b208e42066db886eb37ce9a420fba4a.pdfcolorectal neoplasmsneoadjuvant therapyrectal neoplasmsorgan preservation |
| spellingShingle | Humberto Lyra Junior Luiz Henrique Minatti João Carlos de Oliveira Marlus Gerber Flavia de Novaes Gerber Daniella Vieira José Mauro dos Santos Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years Iranian Journal of Colorectal Research colorectal neoplasms neoadjuvant therapy rectal neoplasms organ preservation |
| title | Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years |
| title_full | Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years |
| title_fullStr | Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years |
| title_full_unstemmed | Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years |
| title_short | Analysis of Rectal Neoplasms Operated After Neoadjuvant Therapy in A Period of 10 Years |
| title_sort | analysis of rectal neoplasms operated after neoadjuvant therapy in a period of 10 years |
| topic | colorectal neoplasms neoadjuvant therapy rectal neoplasms organ preservation |
| url | https://colorectalresearch.sums.ac.ir/article_46989_1b208e42066db886eb37ce9a420fba4a.pdf |
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