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J Gastrointest Cancer. 2021 Sep 01; doi: 10.1007/s12029-021-00697-9. Epub 2021 Sep 01.

Histopathological, Radiological, and Demographic Factors Predicting the Response to Neoadjuvant Therapy for Rectal Cancer.

Journal of gastrointestinal cancer

Emine Yildirim, Sibel Bektas, Zekeriya Pelen, Irem Yanik, Ahmet Muzaffer Er, Ferhat Cengel, Perihan Özkan Gumuskaya

Affiliations

  1. Department of General Surgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey. [email protected].
  2. Department of Pathology, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.
  3. Department of General Surgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.
  4. Department of Radiology, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.
  5. Department of ?nternal Medicine, University of Health Sciences Turkey, Cemil Tascioglu City Hospital, Prof. Dr, Istanbul, Turkey.

PMID: 34472012 DOI: 10.1007/s12029-021-00697-9

Abstract

BACKGROUND/AIM: While the treatment for early stage rectal cancer is surgery, when a diagnosis is made at a locally advanced stage, it is recommended to start treatment with neoadjuvant chemoradiotherapy. Therefore, it is important to determine which patients will respond best to neoadjuvant treatment. The aim of this study was to investigate which hematological, histopathological, and radiological parameters can predict the response to chemoradiotherapy.

METHODS AND MATERIAL: A retrospective examination was made of 43 patients who underwent surgery following neoadjuvant chemoradiotherapy because of locally advanced stage rectal cancer. Demographic data were collected from the patient files, and the radiological, histopathological, and laboratory findings before neoadjuvant chemoradiotherapy were compared with the findings after treatment.

RESULTS: In the postoperative evaluation, a pathological complete response was determined in 25.50% of the patients. Lymphovascular invasion, perineural invasion, and absence of necrosisis were seen to be statistically related to major response (p < 0.05), and in patients where the tumor was closer than 6 cm to the anal verge, the response was better CONCLUSION: When the findings were examined, histopathological lymphovascular invasion, perineural invasion, the presence of necrosis, and the anal verge distance were evaluated as parameters predicting the response to neoadjuvant chemoradiotherapy in rectal cancer.

© 2021. Springer Science+Business Media, LLC, part of Springer Nature.

Keywords: Locally advanced rectal cancer; Lymphovascular invasion; Pathological complete response; Perineural invasion; Response to neoadjuvant therapy

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