Aims and objectives
Neoadjuvant chemoradiotherapy (NCRT) following with total mesorectal excision a period later has become the standard of care for locally advanced rectal cancer (LARC).[1] Some patients can even achieve a pathological complete response (pCR) after NCRT,
associated with an improved local control,
and increased disease-free survival.
Although still controversial,
a “wait and watch” policy or a more conservative surgical treatment has been proposed for patients with complete response to improve their life quality and to reduce the morbidity of surgery.
[2,
3] Therefore it’s important to...
Methods and materials
Patient population: In this retrospective study 43 consecutive patients (ages 31-76,
mean age 55) with LARC (cT3 or T4,
N+) who have completed neoadjuvant chemoradiotherapy (NCRT) and surgery were included between October 2015 and June 2017.
The criteria of pTRG were: 0 (pCR,
no remaining viable cancer cells); 1 (only small clusters cancer cells remaining); 2 (residual cancer remaining,
but with predominant fibrosis); 3(minimal or no tumor kill,
or extensive residual cancer).
Among the enrolled patients,
17 were pTRG0,
7 were pTRG1,
11 were pTRG2,...
Results
15 patients were assessed mrTRG0 (Fig.
1),
9 were mrTRG1 (Fig.
2),
12 were mrTRG2 (Fig.
3),
and 7 were mrTRG3 (Fig.
4).
The median time between preoperational MRI to surgery was 15 days (min 0,
max 31).
mrTRG was moderate agree with pTRG (kappa value= 0.520,
P<0.001,
table 1).
When combining T2-weighted and diffusion weighted imagies in selecting CR,
it showed a good diagnostic ability with a sensitivity of 92.3%,
specificity of 76.5%,
PPV of 92.9%,
and NPV of 86.7%,
and was good in...
Conclusion
The purpose of this study was to identify whether the mrTRG assessed by T2-weighted and diffusion weighted imagies was well corresponding to pTRG,
and to explore its ability in selecting good and complete response after NCRT in LARC.
In our study,
it was found that mrTRG was moderate correspondence with pTRG in general,
but the consistency increased when patients were divided into pCR,
non-pCR and GR,
PR groups.
Our results were similar to Lee et al [8],
who employed a modified 3-point mrTRG.
But Sclafani...
Personal information
lanqing Yang,
M.
M.
S
West china Hospital,
Sichuan University,
Chengdu,
China
E-mail:
[email protected]
References
[1] Lutz M P,
Zalcberg J R,
Glynne-Jones R,
et al.
Second St.
Gallen European Organisation for Research and Treatment of Cancer Gastrointestinal Cancer Conference: consensus recommendations on controversial issues in the primary treatment of rectal cancer.
Eur J Cancer,
2016,
63:11-24.
[2] Habr-Gama A,
Perez R O,
Nadalin W,
et al.
Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results.
Ann Surg,
2004,
240:711-717; discussion 717-718.
[3] Maas M,
Beets-Tan R G,
Lambregts D M,
et al.
Wait-and-see...
