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Published in:

01-02-2007

The Potential of Restaging in the Prediction of Pathologic Response After Preoperative Chemoradiotherapy for Rectal Cancer

Authors: Isacco Maretto, MD, Fabio Pomerri, MD, Salvatore Pucciarelli, MD, Claudia Mescoli, MD, Enrico Belluco, MD, Simona Burzi, MD, Massimo Rugge, MD, Pier Carlo Muzzio, MD, Donato Nitti, MD

Published in: Annals of Surgical Oncology | Issue 2/2007

Abstract

Background

We performed this study to prospectively evaluate the postchemoradiotherapy performance of transrectal ultrasonography (TRUS), pelvic computed tomography (CT) scan and magnetic resonance imaging (MRI), and endoscopic biopsies for predicting the pathologic complete response of rectal cancer patients.

Methods

Four weeks after completion of preoperative chemoradiotherapy, 46 consecutive patients with mid to low rectal cancer were prospectively evaluated by proctoscopy, TRUS, and pelvic CT scan and MRI. On the basis of T and N status, patients were classified as T0 or T1–4 and N-negative or N-positive. For each staging modality used, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Findings were compared with the pathologic tumor-node-metastasis stage.

Results

On histopathologic analysis, 12 patients had pT0 and 34 had pT1–4 lesions; out of 45 assessable patients, 9 were N-positive. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting T status (T0 vs. T ≥1) were 77%, 33%, 74%, 36%, and 64%, respectively, for TRUS; 100%, 0%, 74%, not assessable, and 74% for CT; and 100%, 0%, 77%, not assessable, and 77% for MRI. The corresponding figures in predicting N status (N-negative vs. N-positive) were, respectively, 37%, 67%, 21%, 81%, and 61% for TRUS; 78%, 58%, 32%, 91%, and 62% for CT; and 33%, 74%, 25%, 81%, and 65% for MRI.

Conclusions

Current rectal cancer staging modalities after chemoradiotherapy allow good prediction of node-negative cases, although none of them is able to predict the pathologic complete response on the rectal wall.

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Title: The Potential of Restaging in the Prediction of Pathologic Response After Preoperative Chemoradiotherapy for Rectal Cancer
Authors: Isacco Maretto, MD
Fabio Pomerri, MD
Salvatore Pucciarelli, MD
Claudia Mescoli, MD
Enrico Belluco, MD
Simona Burzi, MD
Massimo Rugge, MD
Pier Carlo Muzzio, MD
Donato Nitti, MD
Publication date: 01-02-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 2/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9269-4

At a glance: The STEP trials

Springer Medicine

The Potential of Restaging in the Prediction of Pathologic Response After Preoperative Chemoradiotherapy for Rectal Cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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