Relationship between histologic response and the degree of tumor shrinkage after chemoradiotherapy in patients with locally advanced rectal cancer.

Abstract

BACKGROUND:

Preoperative chemoradiotherapy (CRT) significantly decreases local recurrence in advanced rectal cancer. We studied whether the degree of tumor shrinkage can be used as a predictor of histologic response.

METHODS:

The subjects were 114 patients with locally advanced rectal cancer who underwent total mesorectal excision after receiving radiotherapy combined with uracil/tegafur (UFT) or S-1. The degree of tumor shrinkage based on barium enema examination and magnetic resonance imaging (MRI) were assessed before CRT and immediately before surgery.

RESULTS:

A histologic complete response (ypCR), histologic marked regression, T and N downstaging were associated with significantly higher tumor-shrinkage rates on barium enema (P < 0.01, P < 0.01, P < 0.01, and P < 0.01, respectively) as well as on MRI (P < 0.01, P < 0.01, P < 0.01, and P = 0.01, respectively). On multivariate analysis, ypCR and histologic marked regression were significantly related only to tumor-shrinkage rates on barium enema (P < 0.01 and P < 0.01, respectively), and were not related to tumor-shrinkage rates on MRI.

CONCLUSIONS:

The degree of tumor shrinkage is closely related to the final histologic response. Two-dimensionally evaluated tumor-shrinkage rates based on barium enema are adequate for the prediction of histologic response.

• Authors: Toshiyuki Suzuki, Sotaro Sadahiro, Akira Tanaka, Kazutake Okada, Gota Saito, Akemi Kamijo, Takeshi Akiba, Shuichi Kawada
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 109 Issue 7 Pg. 659-64 (Jun 2014) ISSN: 1096-9098 [Electronic] United States
• PMID: 24375387 (Publication Type: Journal Article)
• Copyright: © 2013 Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Multivariate Analysis
• Rectal Neoplasms (mortality, pathology, therapy)
• Tomography, X-Ray Computed