Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA.
Am J Surg. 2023 Dec;226(6):873-877. doi: 10.1016/j.amjsurg.2023.07.023. Epub 2023 Jul 13.
Neoadjuvant chemoradiation (NACRT) is the standard of care for locally advanced rectal cancers. The purpose of this study was to determine patient and tumor factors associated with a pathologic complete response (pCR).
The National Surgical Quality Improvement Program proctectomy-targeted database was utilized to identify all patients from 2016 to 2020 who underwent NACRT followed by proctectomy with curative intent for T3-4N0-2 rectal cancers.
A total of 1891 patients were included, of which 253 (13.4%) demonstrated a pCR. Pretreatment N0 staging was associated with a higher rate of pCR (18.9%) when compared to N1 (6.7%) and N2 (6.7%) (p < 0.0001). Patients clinically staged at T3N0 had the highest rate of pCR (19.5%). Gender, age, race, weight, smoking status, and tumor height were not associated with pCR.
Patients with cN0 disease were more likely to experience a pCR compared to cN1-2 patients. Tumor height relative to anal verge or patient demographics were not associated with pCR.
新辅助放化疗（NACRT）是局部晚期直肠癌的标准治疗方法。本研究旨在确定与病理完全缓解（pCR）相关的患者和肿瘤因素。
利用国家手术质量改进计划直肠切除术靶向数据库，确定 2016 年至 2020 年间所有接受 NACRT 后行根治性直肠切除术治疗 T3-4N0-2 期直肠癌的患者。
共纳入 1891 例患者，其中 253 例（13.4%）达到 pCR。与 N1（6.7%）和 N2（6.7%）相比，术前 N0 分期的 pCR 率更高（18.9%）（p<0.0001）。临床分期为 T3N0 的患者 pCR 率最高（19.5%）。性别、年龄、种族、体重、吸烟状况和肿瘤高度与 pCR 无关。
cN0 疾病患者较 cN1-2 患者更有可能出现 pCR。肿瘤高度相对于肛缘或患者人口统计学特征与 pCR 无关。
