Role of the complete pathological response in rectal cancer: Value as a prognostic factor

Abstract

Objective To study the effect of the pathologic complete response (pCR) on the survival of patients treated with surgery and neoadjuvant chemo-radiotherapy in locally advanced non-metastatic rectal carcinoma (LARC). Materials and methodology We underwent an observational retrospective analysis of cohorts. The recruitment was carried out by means of non-probabilistic consecutive inclusion of patients with rectal cancer treated between January 2009 and December 2016 with surgery and neoadjuvant chemo-radiotherapy. The patients recruited had been diagnosed with locally advanced non-metastatic rectal cancer. cT3-4 o N+. based on the American Joint Committee on Cancer (AJCC) 2010. with histological confirmation of adenocarcinoma and no treatment with induction chemotherapy. The pathologic response was calibrated in accordance with the Ryan system. Survival was calculated with multivariate Cox regression analysis Results Pathologic complete response was reached by 19.2% Patients. The disease free survival was significantly lower in the no pathologic complete response (HR 0.099. p value 0.025). The progression in the group of patients with pathological complete response occurred in only one patient and have local and distal component compared to 39 patients in no pCR 21.2% distant metastases and 3.8% locally relapse. Perineural invasion and adjuvant chemotherapy were also significatly associated with disease free survival Conclusions The pathological complete response is a good prognosis factor in patients treated with surgery and nCRT in LARC with distal and local relapse. Perineural invasion and adjuvant chemotherapy were also good prognostic factors.