Clinical Characteristics of Patients with Stage II and Stage III Rectal Cancer and Complete Response after Neoadjuvant Therapy

Activity: Talk or presentation types › Poster presentation

Description

Standard treatment for stage II and III rectal adenocarcinoma (RA) includes neoadjuvant therapy (NAT) followed by surgery. NAT plays a vital role in reducing the size and spread of RA. In 10-20% of cases, a complete clinical response of the RA is observed after NAT. These cases create an opportunity for an alternative treatment plan – the “watch and wait” strategy.. A retrospective study from the year 2015 to 2021 (6 years). Patients with stage II and III RA who received NAT and had a complete clinical (cCR) or pathological response (pCR) after treatment were included.. From 298 patients who received NAT, 26 were selected – 10 had a cCR, and a “watch and wait” strategy was applied, 16 underwent radical surgical treatment and a pCR was found. Mean age – 66.9 years. Gender – 16 female, 10 male. Clinical stages of the RA: stage II – 4, stage III – 22. T stage status: T2–10, T3–15, T4–1. Nodal status: N0–6, N1–13, N2–7. RA differentiation: G1–11, G2–14, carcinoma in situ – 3. Average RA distance from anal verge: 6,7cm. The longest dimension of the RA: min 1,5cm, max 10cm (average 4,9cm). Radiotherapy dose applied: for RA in 1.8Gy fractions up to 50.4Gy-52.2Gy; pelvic lymph nodes 45-46.8Gy, additional lymph node groups – 30.6-37.8Gy. Chemotherapy applied: 5-FU–21, other–4, none–1. The time from the end of radiotherapy to the control MRI of the small pelvis – min 4 weeks, max 14 weeks (avg. 8.3 weeks). Oncomarkers before NAT were elevated in 4 patients – CEA in 3 cases, CA 19-9 in 1 case.. The rate of complete RA response in our study was 8,7% - cCR 3,3%, 5,4% pCR. RA was mainly located in the distal or middle third of the rectum. Pre-treatment node positivity didn't exclude the possibility of a complete response.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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