Can Splenic Characteristics Predict Rectal Cancer Chemotherapy Toxicity and Treatment Outcomes in Rectal Cancer...

Rectal cancer requires multidisciplinary management, including chemotherapy treatment, for successful clinical outcomes. Splenic characteristics on computed tomography (CT) imaging have been proposed to reflect immune function. This study explores whether splenic size and density on pretreatment CT scans predicts chemotherapy dose-limiting toxicities (DLTs) and cancer outcomes in rectal cancer patients.

A retrospective study of rectal cancer patients who received chemotherapy treatment with curative intent from February 2013 to March 2023 was conducted. Pretreatment CT scans were collected for measurement of splenic volume and density. Receiver operating characteristics analyses of splenic density and volume was performed to calculate the area under the curve (AUC). The AUC was used to determine association with overall survival (OS), disease-free survival (DFS), and DLT.

A total of 234 patients were included, and 98 (41.8%) patients were classified as having diffuse reduction of spleen density (DROSD). The DROSD group experienced significantly reduced DLTs (13.3% vs. 24.3%, p = 0.045). There was no significant association between OS or DFS with splenic volume or density.

This study has shown that DROSD is an independent predictive factor for reduced DLT in rectal cancer patients undergoing chemotherapy treatment. Further research is needed to validate findings and elucidate underlying mechanisms.