Is Early, Postinduction Restaging of Rectal Cancer Undergoing Total Neoadjuvant Therapy Associated With Ultimate...

Area of Science:

• Oncology
• Gastroenterology
• Medical Imaging

Background:

• Total neoadjuvant therapy (TNT) is used for rectal cancer.
• The association between early restaging and final tumor response after TNT is not well-defined.
• Interim restaging may influence treatment decisions in rectal cancer management.

Purpose of the Study:

• To determine if postinduction restaging using endoscopy and MRI correlates with final tumor response in rectal cancer patients undergoing TNT.

Main Methods:

• Retrospective cohort study.
• Included patients with biopsy-proven rectal cancer treated with TNT and interim restaging.
• Assessed the association between postinduction restaging response and final treatment response.

Main Results:

• 107 patients were analyzed.
• Postinduction MRI grade 1-2 or complete endoscopic response predicted higher likelihood of final complete response (OR 5.4, p<0.01 and OR 3.7, p=0.03).
• Postinduction partial or minimal responses were associated with significantly higher odds of final incomplete response (OR 4.1, p<0.01 and OR 12.0, p<0.01).

Conclusions:

• Tumor response to induction therapy is linked to ultimate treatment response in TNT for complete or minimal responders.
• The clinical significance of a partial interim response requires further investigation.
• Limitations include retrospective design, limited sample size, and lack of detailed subclassification for partial endoscopic response.