Sun Gyo Lim1, Young Bae Kim2, Seung Yeop Oh3. 1. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. 2. Department of Pathology, Ajou University School of Medicine, Suwon, Korea. 3. Department of Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, 443-721, Korea. kgsosy@ajou.ac.kr.
Abstract
BACKGROUND: There are reports that suggest conservative treatment when a tumor shows clinically complete response (CR) after preoperative chemoradiotherapy in rectal cancer. The aim of this study is to investigate the association between endoscopic complete response (E-CR) and pathologic CR (pCR) and to determine the sensitivity and specificity of E-CR and its clinical utility after preoperative chemoradiotherapy in rectal cancer. METHODS: We analyzed prospectively collected data of patients with middle and lower rectal cancers who underwent preoperative chemoradiotherapy, between January 2010 and January 2015. RESULTS: Nineteen patients (17.9 %) showed E-CR, and 87 patients showed E-non CR. Twenty-three patients (21.7 %) were confirmed to have pCR. E-CR was closely associated with pCR (p < 0.001). E-CR reflected pCR with an accuracy of 88.7 %, sensitivity of 65.2 %, specificity of 95.2 %, PPV of 78.9 %, NPV of 90.8 %, and a p value of <0.001. CONCLUSIONS: E-CR after preoperative chemoradiotherapy in rectal cancer is significantly associated with pCR. However, a wait and see policy should be performed carefully with current endoscopic prediction for pCR to avoid inadequate treatment in patients who show E-CR after preoperative chemoradiotherapy.
BACKGROUND: There are reports that suggest conservative treatment when a tumor shows clinically complete response (CR) after preoperative chemoradiotherapy in rectal cancer. The aim of this study is to investigate the association between endoscopic complete response (E-CR) and pathologic CR (pCR) and to determine the sensitivity and specificity of E-CR and its clinical utility after preoperative chemoradiotherapy in rectal cancer. METHODS: We analyzed prospectively collected data of patients with middle and lower rectal cancers who underwent preoperative chemoradiotherapy, between January 2010 and January 2015. RESULTS: Nineteen patients (17.9 %) showed E-CR, and 87 patients showed E-non CR. Twenty-three patients (21.7 %) were confirmed to have pCR. E-CR was closely associated with pCR (p < 0.001). E-CR reflected pCR with an accuracy of 88.7 %, sensitivity of 65.2 %, specificity of 95.2 %, PPV of 78.9 %, NPV of 90.8 %, and a p value of <0.001. CONCLUSIONS:E-CR after preoperative chemoradiotherapy in rectal cancer is significantly associated with pCR. However, a wait and see policy should be performed carefully with current endoscopic prediction for pCR to avoid inadequate treatment in patients who show E-CR after preoperative chemoradiotherapy.
Authors: Luis Joaquín García-Flórez; Guillermo Gómez-Álvarez; Ana Madalina Frunza; Luis Barneo-Serra; Carmen Martínez-Alonso; Manuel Florentino Fresno-Forcelledo Journal: J Surg Res Date: 2014-10-08 Impact factor: 2.192
Authors: Mark S Roh; Linda H Colangelo; Michael J O'Connell; Greg Yothers; Melvin Deutsch; Carmen J Allegra; Morton S Kahlenberg; Luis Baez-Diaz; Carol S Ursiny; Nicholas J Petrelli; Norman Wolmark Journal: J Clin Oncol Date: 2009-09-21 Impact factor: 44.544
Authors: C M Dolinsky; N N Mahmoud; R Mick; W Sun; R W Whittington; L J Solin; D G Haller; B J Giantonio; P J O'Dwyer; E F Rosato; R D Fry; J M Metz Journal: J Surg Oncol Date: 2007-09-01 Impact factor: 3.454