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Published on: February 12, 2017
Post-induction MRI response is associated with complete response and recurrence-free survival in rectal cancer
Yu Shen1, Xiaoling Gong2, Tianxiang Jiang1
1Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Objective:
To evaluate the association between post-induction MRI response after induction chemotherapy and final treatment response in locally advanced rectal cancer (LARC) patients undergoing total neoadjuvant therapy.
Methods:
This retrospective study included LARC patients who underwent induction chemotherapy-based total neoadjuvant therapy followed by total mesorectal excision (TME). MRI tumor regression grade and tumor longitudinal length reduction rate (TLLR) were used to assess post-induction response. MRI tumor regression grade and diffusion-weighted imaging were used to determine preoperative MRI complete response (mriCR). The primary outcome was the pathological complete response (pCR).
Results:
The current study included 224 patients (56 [IQR 49-65] years). Good responders at post-induction evaluation were associated with higher mriCR (OR 3.78, p < 0.001), higher pCR (OR 4.41, p < 0.001), and better recurrence-free survival (p < 0.001).
Conclusion:
Post-induction evaluation was associated with later mriCR, pCR, and recurrence-free survival in LARC patients undergoing total neoadjuvant therapy, supporting future study on response-adapted neoadjuvant strategies.