Yeqian Huang1, Daniel Lee2, Christopher Young3. 1. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia, 2050; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia. Electronic address: yeqian.huang@hotmail.com. 2. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia, 2050; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia. 3. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia, 2050; Discipline of Surgery, The University of Sydney, Sydney, NSW, Australia. Electronic address: christopher.young@sydney.edu.au.
Abstract
BACKGROUND: There has been an increasing interest in the complete pathological response (pCR) in rectal cancers following neoadjuvant therapy. The aim of this study was to identify predictive factors of pCR in locally advanced rectal cancer following neoadjuvant therapy. METHODS: The studies identified were appraised with standard selection criteria. The selection criteria included studies on patients with stage II or III rectal cancer who underwent neoadjuvant therapy. RESULTS: Patients with pCR are more likely to be older (p = 0.0002), have cancers closer distance to the anal verge (p < 0.00001), smaller tumors (P < 0.0001), no clinical lymph nodes involvement (p=<0.00001) and waited more than eight weeks until definitive surgery (p = 0.002). There was no difference in gender (p = 0.15) and tumor differentiation (p = 0.21). CONCLUSIONS: The 'Watch and Wait' approach may be appropriate for selected patients. Patients with lower rectal cancers, smaller tumors, and negative clinical lymph node involvement may be more likely to achieve pCR following neoadjuvant therapy.
BACKGROUND: There has been an increasing interest in the complete pathological response (pCR) in rectal cancers following neoadjuvant therapy. The aim of this study was to identify predictive factors of pCR in locally advanced rectal cancer following neoadjuvant therapy. METHODS: The studies identified were appraised with standard selection criteria. The selection criteria included studies on patients with stage II or III rectal cancer who underwent neoadjuvant therapy. RESULTS:Patients with pCR are more likely to be older (p = 0.0002), have cancers closer distance to the anal verge (p < 0.00001), smaller tumors (P < 0.0001), no clinical lymph nodes involvement (p=<0.00001) and waited more than eight weeks until definitive surgery (p = 0.002). There was no difference in gender (p = 0.15) and tumor differentiation (p = 0.21). CONCLUSIONS: The 'Watch and Wait' approach may be appropriate for selected patients. Patients with lower rectal cancers, smaller tumors, and negative clinical lymph node involvement may be more likely to achieve pCR following neoadjuvant therapy.
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