William C Chapman, Emre Gorgun, Sumeyye Yilmaz, David R Rosen, Michael Valente, Josh Sommovilla, Arielle Kanters, Andrei Purysko, Alok Khorana, Smitha Krishnamurthi, Sudha Amarnath, Hermann Kessler, Scott Steele, David Liska
{"title":"Is Early, Post-Induction Restaging of Rectal Cancer Undergoing Total Neoadjuvant Therapy Associated With Ultimate Treatment Response?","authors":"William C Chapman, Emre Gorgun, Sumeyye Yilmaz, David R Rosen, Michael Valente, Josh Sommovilla, Arielle Kanters, Andrei Purysko, Alok Khorana, Smitha Krishnamurthi, Sudha Amarnath, Hermann Kessler, Scott Steele, David Liska","doi":"10.1097/DCR.0000000000003485","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Among rectal cancer patients treated with Total Neoadjuvant Therapy, it is unclear whether early, post-induction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making.</p><p><strong>Objective: </strong>To determine if post-induction restaging with endoscopy and magnetic resonance imaging is associated with final tumor response.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer.</p><p><strong>Patients: </strong>Biopsy-proven rectal cancer patients who underwent Total Neoadjuvant Therapy with interim (post-induction) restaging.</p><p><strong>Main outcome measures: </strong>Association between response assessment on post-induction restaging and final treatment response.</p><p><strong>Results: </strong>107 patients were analyzed. Patients with post-induction magnetic resonance tumor response grade 1 - 2 or complete endoscopic response were significantly more likely (odds ratio 5.4 [p < 0.01] and odds ratio 3.7 [p = 0.03], respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with post-induction composite partial (odds ratio 4.1, p < 0.01) or minimal (odds ratio 12.0, p < 0.01) responses.</p><p><strong>Limitations: </strong>Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of this data. Limited sample size may also have biased these conclusions.</p><p><strong>Conclusion: </strong>Tumor response to induction therapy is associated with ultimate treatment response to Total Neoadjuvant Therapy among complete or minimal responders; the significance of a partial interim response remains unclear. See Video Abstract.</p>","PeriodicalId":11299,"journal":{"name":"Diseases of the Colon & Rectum","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diseases of the Colon & Rectum","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/DCR.0000000000003485","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Among rectal cancer patients treated with Total Neoadjuvant Therapy, it is unclear whether early, post-induction restaging is associated with final tumor response. If so, interim restaging may alter rectal cancer decision-making.
Objective: To determine if post-induction restaging with endoscopy and magnetic resonance imaging is associated with final tumor response.
Design: Retrospective cohort study.
Settings: US tertiary care institution accredited by the National Accreditation Program for Rectal Cancer.
Patients: Biopsy-proven rectal cancer patients who underwent Total Neoadjuvant Therapy with interim (post-induction) restaging.
Main outcome measures: Association between response assessment on post-induction restaging and final treatment response.
Results: 107 patients were analyzed. Patients with post-induction magnetic resonance tumor response grade 1 - 2 or complete endoscopic response were significantly more likely (odds ratio 5.4 [p < 0.01] and odds ratio 3.7 [p = 0.03], respectively) to ultimately achieve a final complete response. Likewise, the odds of a final incomplete response were significantly higher for patients with post-induction composite partial (odds ratio 4.1, p < 0.01) or minimal (odds ratio 12.0, p < 0.01) responses.
Limitations: Retrospective analysis and lack of detailed subclassification of partial endoscopic response may have limited the conclusions of this data. Limited sample size may also have biased these conclusions.
Conclusion: Tumor response to induction therapy is associated with ultimate treatment response to Total Neoadjuvant Therapy among complete or minimal responders; the significance of a partial interim response remains unclear. See Video Abstract.
期刊介绍:
Diseases of the Colon & Rectum (DCR) is the official journal of the American Society of Colon and Rectal Surgeons (ASCRS) dedicated to advancing the knowledge of intestinal disorders by providing a forum for communication amongst their members. The journal features timely editorials, original contributions and technical notes.