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- Title
Response to neoadjuvant treatment among rectal cancer patients in a population-based cohort.
- Authors
Alwers, Elizabeth; Jansen, Lina; Kather, Jakob; Amitay, Efrat; Bläker, Hendrik; Kloor, Matthias; Tagscherer, Katrin E.; Roth, Wilfried; Herpel, Esther; Chang-Claude, Jenny; Brenner, Hermann; Hoffmeister, Michael
- Abstract
Background: In rectal cancer, prediction of tumor response and pathological complete response (pCR) to neoadjuvant treatment could contribute to refine selection of patients who might benefit from a delayed- or no-surgery approach. The aim of this study was to explore the association of clinical and molecular characteristics of rectal cancer with response to neoadjuvant treatment and to compare patient survival according to level of response. Methods: Resected rectal cancer patients were selected from a population-based cohort study. Molecular tumor markers were determined from the surgical specimen. Tumor response and pCR were defined as downstaging in T or N stage and absence of tumor cells upon pathological examination, respectively. The associations of patient and tumor characteristics with tumor response and pCR were explored, and patient survival was determined by degree of response to neoadjuvant treatment. Results: Among 1536 patients with rectal cancer, 602 (39%) received neoadjuvant treatment. Fifty-five (9%) patients presented pCR, and 239 (49%) and 250 (53%) patients showed downstaging of the T and N stages, respectively. No statistically significant associations were observed between patient or tumor characteristics and tumor response or pCR. Patients who presented any type of response to neoadjuvant treatment had significantly better cancer-specific and overall survival compared with non-responders. Conclusion: In this study, patient characteristics were not associated with response to neoadjuvant treatment, and molecular characteristics determined after surgical resection of the tumor were not predictive of pCR or tumor downstaging. Future studies should include molecular biomarkers from biopsy samples before neoadjuvant treatment.
- Subjects
CANCER patients; RECTAL cancer; TUMOR markers; PATIENT selection; SURGICAL excision; MOLECULAR association
- Publication
International Journal of Colorectal Disease, 2021, Vol 36, Issue 1, p177
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-020-03744-2