Predicting stage ypT0–1N0 for nonradical management in patients with middle or low rectal cancer who undergo neoadjuvant chemoradiotherapy: a retrospective cohort study
Year: 2022
Type: article
Study design: Observational Study
Abstract: Purpose: It is important to discover predictive factors that can identify rectal cancer patients who will respond well to neoadjuvant concurrent chemoradiotherapy (CCRT) to develop management strategies, preserve sphincter and avoid over-treatment. This study explored clinical factors that would predict the adequacy of nonradical management after CCRT in patients with middle or low rectal cancer. Methods: We retrospectively evaluated 447 patients with middle or low rectal cancer who were treated with curative surgery after neoadjuvant CCRT between January 2010 and December 2019. The good response group comprised patients with stages ypT0-1N0 on resection after CCRT; the remaining patients were included in the poor response group. Results: 19.2% with lateral/encircling direction, P = 0.016) had stage ypT0-1N0. On multivariable analysis, cT1-2 (P = 0.021) and well-differentiated tumor (P = 0.001) were independent predictors of ypT0-1N0. Fungating tumors were not significantly associated with ypT0-1N0 (P = 0.054). Conclusion: Stage cT1-2 and well differentiation are predictors of ypT0-1N0, while fungating tumors could be considered clinically meaningful, possibly identifying candidates for nonradical treatment post-CCRT.
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4286355258