Prognostic Implications of Pathological Response to Neoadjuvant Chemoradiation in Pathologic Stage III Rectal Cancer

Annals of Surgery
Georgios KaragkounisMatthew F Kalady

Abstract

To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in rectal cancer. AJCC regression scores have been shown to correlate with prognosis. Patient demographics, tumor characteristics, and AJCC scores (0 = complete response; 1 = isolated tumor cells remaining; 2 = residual cancer outgrown by fibrosis; 3 = extensive residual cancer) were assessed from 545 rectal cancer patients treated by nCRT followed by surgery at a single institution. Patients were classified as responders (score 0-2) or nonresponders (score 3). Survival analyses were performed using Cox proportional hazards models. Of 545 cases, 123 and 182 were pathologic stage II and III, respectively. Median follow-up was 4.9 years. AJCC regression scores were not independently prognostic within stage II cancers. However, AJCC scores were strongly associated with prognosis within stage III cancers (nonresponse 5-year overall survival [OS] 27% vs 67%, P < 0.001). Stage III responders (N = 139, 76.4%) had similar outcomes to stage II (5-year ...Continue Reading

References

Oct 26, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Claus RödelChristian Wittekind
Apr 25, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Rolf SauerClaus Rödel
Oct 10, 2013·Diseases of the Colon and Rectum·Adam G MaceMatthew F Kalady
Apr 23, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Emmanouil FokasClaus Rödel
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Jul 15, 2015·Diseases of the Colon and Rectum·Scott R SteeleUNKNOWN Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons

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Citations

Oct 1, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·C TerziI Oztop
Nov 16, 2019·The Journal of Experimental Medicine·Junjie ZhaoXiaoxia Li
Feb 8, 2020·Diseases of the Colon and Rectum·Sean C Glasgow
Jul 15, 2020·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Lama FarchoukhReetesh K Pai
Nov 21, 2020·Diseases of the Colon and Rectum·Y Nancy YouUNKNOWN On Behalf of the Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons

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