Introduction: In the European randomized trials of neoadjuvant
CRT the rate of complete response ranged from 11-16%. The aim of
our analysis was verify whether ypCR predicts a favourable outcome.
Methods: 234 patients with locally advanced low and mid rectal
cancer underwent neoadjuvant chemoradiation Eligibility criteria included
locally advanced rectal cancer with no evidence of distant metastases
at the time of the diagnosis and evidence of ypCR after the neoadjuvant
treatment.
Results: 37 patients had a complete response and 78 patient were
not responders. Median follow up was 60 months. In ypCR patients no
locoregional recurrence occured and distant metastases occured in 2 patients
(5,4%). In the not responder group we found 18 local recurrence
and 46 patients developped distant metastases The ypCR group 5-years
overall and disease free survival were 97% and 94% rispectively. During
the follow up one patient died.
Conclusions: The improved oncological outcome in patients with
rectal cancer who achieve a ypCR appears related to their significantly
decreased rate of distant failure whencompared with no down staging
patients.
