Stratified Prognostic Value of Pathological Response to Preoperative Treatment in yp II/III Rectal Cancer

Accumulated studies have verified that tumor regression is associated with the prognosis of rectal cancer. However, stratified analysis within a certain stage is still unknown. The purpose of our study was to assess the impact of pathologic response on the survival of stageII and III rectal cancer p...

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Published inFrontiers in oncology Vol. 11; p. 795137
Main Authors Yang, Yanpeng, Xu, Hao, Chen, Guowei, Pan, Yisheng
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 16.12.2021
Subjects
neoadjuvant (chemo)radiotherapy
Oncology
prognosis
rectal cancer
survival
tumor regression grade (TRG)
neoadjuvant (chemo)radiotherapy
tumor regression grade (TRG)
prognosis
rectal cancer
survival
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Summary:Accumulated studies have verified that tumor regression is associated with the prognosis of rectal cancer. However, stratified analysis within a certain stage is still unknown. The purpose of our study was to assess the impact of pathologic response on the survival of stageII and III rectal cancer patients after neoadjuvant chemoradiotherapy (nCRT). Clinicopathologic characteristics and tumor regression scores (TRS) were assessed in 236 rectal cancer patients who treated with nCRT followed by surgery. Survival analysis was performed using Cox proportional hazards models. Among these patients, the stage of 88 patients was ypII, and 91 patients were with the stage of ypIII. The median follow-up time was 59.8 months. TRS was not an independent prognostic factor in ypII patients while it was significantly associated with the prognosis of ypIII patients (5-year survival rate 67.2% vs. 42.5%, < 0.001). Furthermore, ypIII patients with the response to nCRT had similar survival to that of ypII patients (5-year survival rate 67.2% vs. 70.5%, = 0.56). For ypIII patients, multivariable analysis showed that well differentiation, negative surgical margin, and the administration of adjuvant chemotherapy were associated with better survival. The surgical margin and differentiation were prognostic factors for ypII patients. ypIII rectal cancer patients with poor response to preoperative treatment are at high risk of worse oncological outcomes.
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Edited by: Silvia R. Rogatto, University of Southern Denmark, Denmark
This article was submitted to Gastrointestinal Cancers: Colorectal Cancer, a section of the journal Frontiers in Oncology
Reviewed by: Thomas Samuel Ram, Christian Medical College & Hospital, India; Marco Massani, ULSS2 Marca Trevigiana, Italy
These authors have contributed equally to this work and share first authorship
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2021.795137