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International Journal of Colorectal Disease

Published in:

01-01-2011 | Original Article

Signet ring cell histology and non-circumferential tumors predict pathological complete response following neoadjuvant chemoradiation in rectal cancers

Authors: Sunil Bhanu Jayanand, Ramakrishnan Ayloor Seshadri, Ritesh Tapkire

Published in: International Journal of Colorectal Disease | Issue 1/2011

Abstract

Purpose

Neoadjuvant chemoradiation followed by surgery is now the standard of care for patients with locally advanced rectal cancers. The aim of this study was to determine the rate of pathological complete response (pCR) following neoadjuvant treatment in patients with rectal cancers and identify the factors predicting the same.

Methods

We conducted a retrospective analysis of patients with rectal cancers treated with neoadjuvant therapy followed by surgery at our institution from 1993 to 2008. Patients who achieved pCR were identified. Various patient, tumor, and treatment-related factors were studied for their influence on pCR by univariate and multivariate analyses. The influence of pCR on survival was also studied but was restricted to patients with a minimum follow-up of 5 years.

Results

Between 1993 and 2008, 248 patients with rectal cancers received neoadjuvant therapy followed by surgery. Two hundred and twenty-seven patients received chemoradiation and 21 patients received only radiation. Pathological complete response was seen in 32 patients (12.9%). On multivariate analysis, the factors found to be independently predictive of pathological response were circumferential extent of the primary tumor (p = 0.016) and signet ring cell histology (p = 0.001). Among 116 patients with a minimum follow-up of 5 years, there was a trend towards increased overall survival (75% versus 54%) and reduced local recurrence (6.2%versus 12.3%) in the 16 patients who achieved a pCR compared to those who did not, even though the difference was not statistically significant.

Conclusions

The factors that predict a pCR after neoadjuvant treatment for rectal cancers are absence of circumferential involvement and signet ring cell histology. Pathological complete response may confer an insignificant survival advantage.

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Title: Signet ring cell histology and non-circumferential tumors predict pathological complete response following neoadjuvant chemoradiation in rectal cancers
Authors: Sunil Bhanu Jayanand
Ramakrishnan Ayloor Seshadri
Ritesh Tapkire
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 1/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-010-1082-7

At a glance: The STEP trials

Springer Medicine

Signet ring cell histology and non-circumferential tumors predict pathological complete response following neoadjuvant chemoradiation in rectal cancers

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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