Predicting tumor response after preoperative chemoradiation using clinical parameters in rectal cancer

AIM： To evaluate the clinical parameters and identify a better method of predicting pathological complete response （pCR）. METHODS： We enrolled 249 patients from a database of 544 consecutive rectal cancer patients who underwent surgical resection after preoperative chemoradiation therapy （PCRT）. A r...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2011-12, Vol.17 (48), p.5310-5316
Main Authors: Park, Chan Ho, Kim, Hee Cheol, Cho, Yong Beom, Yun, Seong Hyeon, Lee, Woo Yong, Park, Young Suk, Choi, Doo Ho, Chun, Ho-Kyung
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Area Under Curve
Brief
Chemoradiotherapy - methods
Female
Humans
Male
Middle Aged
Multivariate Analysis
Rectal Neoplasms - drug therapy
Rectal Neoplasms - pathology
Rectal Neoplasms - radiotherapy
Rectal Neoplasms - surgery
Retrospective Studies
Treatment Outcome
Young Adult
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Summary:AIM： To evaluate the clinical parameters and identify a better method of predicting pathological complete response （pCR）. METHODS： We enrolled 249 patients from a database of 544 consecutive rectal cancer patients who underwent surgical resection after preoperative chemoradiation therapy （PCRT）. A retrospective review of morphological characteristics was then performed to collect data regarding rectal examination findings. A scoring model to predict pCR was then created. To validate the ability of the scoring model to predict complete regression. RESULTS： Seventy patients （12.9%） achieved a pCR. A multivariate analysis found that pre-CRT movability （P = 0.024）, post-CRT size （P = 0.018）, post-CRT morphology （P = 0.023）, and gross change （P = 0.009） were independent predictors of pCR. The accuracy of the scoring model was 76.8% for predicting pCR with the threshold set at 4.5. In the validation set, the accuracy was 86.7%. CONCLUSION： Gross changes and morphological findings are important predictors of pathological response. Accordingly, PCRT response is best predicted by a combination of clinical, laboratory and metabolic information.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i48.5310