Multimodal Assessments are needed for Restaging after Neoadjunvant Chemoradiation Therapy in Rectal Cancer Patients

Cancer Research and Treatment : Official Journal of Korean Cancer Association
Bong-Hyeon KyeHyeon-Min Cho

Abstract

Restaging after neoadjuvant treatment is done for planning the surgical approach and, increasingly, to determine whether additional therapy or resection can be avoided for selected patients. Local restaging after nCRT was performed in 270 patients with locally advanced (cT3or4 or N+) rectal cancer. APCT was used in all 270 patients, TRUS in 121 patients, and rectal MRI in 65 patients. Findings according to imaging modalities were correlated with pathologic stage using Cohen's kappa (κ) to test agreement and Intra-Class Correlation Coefficient (ICC) α to test reliability. Accuracy for prediction of yp T stage according to three imaging modalities was 45.2% (κ=0.136, α=0.380) in APCT, 49.2% (κ=0.259, α=0.514) in rectal MRI, and 57.9% (κ=0.266, α=0.520) in TRUS. Accuracy for prediction of yp N stage was 66.0% (κ=0.274, α=0.441) in APCT, 71.8% (κ=0.401, α=0.549) in rectal MRI, and 66.1% (κ=0.147, α=0.272) in TRUS. Of 270 patients, 37 (13.7%) were diagnosed as pathologic complete responder after nCRT. Rectal MRI for restaging did not predict complete response. On the other hand, TRUS did predict three complete responders (κ=0.238, α=0.401). s APCT, rectal MRI, and TRUS are unreliable in restaging rectal cancer after nCRT. We think t...Continue Reading

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Citations

Feb 9, 2017·Diseases of the Colon and Rectum·Joris J van den BroekW Hermien Schreurs

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BETA
imaging techniques

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