Pathological Complete Response after Neoadjuvant Therapy in
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Neoadjuvant therapy is the gold standard treatment of locally advanced rectal cancer. It may induce complete sterilization of tumor cell and decreases its local recurrence rate.

Pathological complete response (pCR) rate can indicate the suitability of applying the “watch-and-wait” strategy, which advocates deferment of surgery that can alleviate surgery-associated morbidity. This surgery was aimed to determine the percentage of pCR of rectal cancer after neoadjuvant therapy.

Patients diagnosed with rectal cancer who underwent treatment were retrieved retrospectively. Demographic data, tumor localization, pre- and post-operative pathological reports, neoadjuvant therapy, and pCR status were collected from patients’ records. A total of 242 out of 259 patients were treated with definitive rectal surgery. The mean age was 67.1 years old. Chinese ethnicity and male gender were predominant.

--More than half had tumors located at the mid or low rectum.

--Histologically, moderately differentiated adenocarcinoma was predominant.

--Merely half of the patients received neoadjuvant chemoradiation therapy, but only 12 had a pCR.

--From follow-up on these 12 pCR patients, most had 2-year disease-free survival but 1 of the pCR had distant metastasis within 1-year post-surgery.

--The pathological complete response rate in the center was lower than reported.

"Stringent patient selection with close follow-up for patients should be carried out if the “watch-and-wait” strategy is implemented in the population," says the authors.

Indian Journal of Surgery
Source: https://doi.org/10.1007/s12262-021-02945-5
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