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The Impact of Pathologic Complete Response in Patients with Neoadjuvantly Treated Locally Advanced Rectal Cancer-a
A M Dinaux1, R Amri1, L G Bordeianou1
1Department of General and Gastrointestinal Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Summary
Achieving pathologic complete response (PathCR) after neoadjuvant treatment for rectal cancer significantly improves long-term survival. Patients with PathCR experienced longer recurrence-free and overall survival compared to those with residual disease.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Neoadjuvant treatment followed by surgery is standard for locally advanced rectal cancer.
- Pathologic complete response (PathCR) is associated with improved outcomes, but long-term data from large cohorts are limited.
Purpose of the Study:
- To evaluate the long-term oncologic outcomes of patients with locally advanced rectal cancer who achieved PathCR after neoadjuvant chemoradiation.
- To assess the impact of PathCR on recurrence-free survival (RFS) and overall survival (OS).
Main Methods:
- Retrospective analysis of a single-center cohort of 271 patients with clinical stage II/III rectal cancer treated between 2004 and 2014.
- Neoadjuvant chemoradiation followed by surgery.
- Cox regression analysis to determine the influence of PathCR on RFS and OS, adjusting for relevant covariates.
Main Results:
- Patients achieving PathCR had significantly lower distant recurrence rates (4% vs. 15.8%) and disease-specific mortality (0% vs. 8.1%) compared to those with residual disease.
- PathCR was significantly associated with longer RFS (HR, 5.6) and OS (HR, 3.4).
Conclusions:
- Pathologic complete response after neoadjuvant chemoradiation is a significant predictor of improved long-term recurrence-free and overall survival in locally advanced rectal cancer.
- These findings support the importance of achieving PathCR in rectal cancer treatment strategies.
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