Characteristics of pathologic complete response for locally advanced rectal cancer.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
12 2023
Historique:
received: 24 03 2023
revised: 09 07 2023
accepted: 11 07 2023
medline: 27 11 2023
pubmed: 18 7 2023
entrez: 17 7 2023
Statut: ppublish

Résumé

Neoadjuvant chemoradiation (NACRT) is the standard of care for locally advanced rectal cancers. The purpose of this study was to determine patient and tumor factors associated with a pathologic complete response (pCR). The National Surgical Quality Improvement Program proctectomy-targeted database was utilized to identify all patients from 2016 to 2020 who underwent NACRT followed by proctectomy with curative intent for T3-4N0-2 rectal cancers. A total of 1891 patients were included, of which 253 (13.4%) demonstrated a pCR. Pretreatment N0 staging was associated with a higher rate of pCR (18.9%) when compared to N1 (6.7%) and N2 (6.7%) (p < 0.0001). Patients clinically staged at T3N0 had the highest rate of pCR (19.5%). Gender, age, race, weight, smoking status, and tumor height were not associated with pCR. Patients with cN0 disease were more likely to experience a pCR compared to cN1-2 patients. Tumor height relative to anal verge or patient demographics were not associated with pCR.

Sections du résumé

BACKGROUND
Neoadjuvant chemoradiation (NACRT) is the standard of care for locally advanced rectal cancers. The purpose of this study was to determine patient and tumor factors associated with a pathologic complete response (pCR).
METHODS
The National Surgical Quality Improvement Program proctectomy-targeted database was utilized to identify all patients from 2016 to 2020 who underwent NACRT followed by proctectomy with curative intent for T3-4N0-2 rectal cancers.
RESULTS
A total of 1891 patients were included, of which 253 (13.4%) demonstrated a pCR. Pretreatment N0 staging was associated with a higher rate of pCR (18.9%) when compared to N1 (6.7%) and N2 (6.7%) (p < 0.0001). Patients clinically staged at T3N0 had the highest rate of pCR (19.5%). Gender, age, race, weight, smoking status, and tumor height were not associated with pCR.
CONCLUSIONS
Patients with cN0 disease were more likely to experience a pCR compared to cN1-2 patients. Tumor height relative to anal verge or patient demographics were not associated with pCR.

Identifiants

pubmed: 37460372
pii: S0002-9610(23)00337-9
doi: 10.1016/j.amjsurg.2023.07.023
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

873-877

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors of this manuscript have no relevant financial disclosures.

Auteurs

Adam J Cloos (AJ)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Makayla Schissel (M)

Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.

Rishi Batra (R)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Steven R Donahue (SR)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Chelsea D Wenos (CD)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Terrence Kumar (T)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Jennifer A Leinicke (JA)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Jon S Thompson (JS)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Sean J Langenfeld (SJ)

Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: https://twitter.com/SeanLangenfeld.

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