VOLUME 30 - NUMBER 51 - 2009

Prognostic value of pathological complete response after neoadiuvant therapy for locally advanced rectal cancer

  • Tamburini A., Bencardino K., Orsenigo E., Di Palo S., Albarello L., Ronzoni M., Staudacher C.
  • Articolo Originale, 235-236
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  • 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.

  • KEY WORDS: rectal cancer, neoadjuvant therapy, prognosis.