Zhong Xiaoling, Zeng Guohua, Zhang Lixiang, You Shuyuan, Fu Yuxiang, He Wan, Liao Guixiang
Department of Radiology, Shenzhen People's Hospital (The Second Clinical Medical College of Jinan University, the First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, Guangdong, China.
Department of Pathology, Shenzhen People's Hospital (The Second Clinical Medical College of Jinan University, the First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, China.
Front Oncol. 2024 Mar 11;14:1361300. doi: 10.3389/fonc.2024.1361300. eCollection 2024.
To investigate the predictive factors of pathologic complete response (pCR) in locally advanced rectal cancer (LARC) patients who had been treated with neoadjuvant chemoradiation (nCRT).
For this retrospective study, 53 LARC patients (37 males and 16 females; age range 25 to 79 years) were selected. Clinical characteristics, baseline mrTNM staging, MR gross tumor volumes (GTV), and pCR were evaluated. The diagnostic accuracy of GTV for predicting pCR was calculated.
Among 53 LARC patients, 15 patients achieved pCR (28.3%), while 38 patients achieved non-pCR. Only three (5.7%) out of 53 patients did not downstage after nCRT. GTV and tumor differentiation were the significant prognostic parameters for predicting pCR. A tumor volume threshold of 21.1 cm was determined as a predictor for pCR, with a sensitivity of 84% and specificity of 47%. In addition, GTV was associated with mrN stage, circumferential resection margin (CRM) status, extramural vascular invasion (EMVI) status, and pretreatment serum CEA level.
Tumor volume and tumor differentiation have significant predictive values in preoperative assessment of pCR among LARC patients. These findings aid clinicians to discriminate those patients who may likely benefit from preoperative regimens and to make optimal treatment plans.
探讨接受新辅助放化疗（nCRT）的局部晚期直肠癌（LARC）患者病理完全缓解（pCR）的预测因素。
本回顾性研究选取了53例LARC患者（37例男性和16例女性；年龄范围25至79岁）。评估了临床特征、基线mrTNM分期、磁共振成像（MR）总肿瘤体积（GTV）和pCR情况。计算了GTV预测pCR的诊断准确性。
53例LARC患者中，15例达到pCR（28.3%），38例未达到pCR。53例患者中只有3例（5.7%）在nCRT后未降期。GTV和肿瘤分化是预测pCR的重要预后参数。确定肿瘤体积阈值为21.1 cm作为pCR的预测指标，敏感性为84%，特异性为47%。此外，GTV与mrN分期、环周切缘（CRM）状态、壁外血管侵犯（EMVI）状态及术前血清癌胚抗原（CEA）水平相关。
肿瘤体积和肿瘤分化在LARC患者术前评估pCR方面具有重要预测价值。这些发现有助于临床医生辨别那些可能从术前治疗方案中获益的患者，并制定最佳治疗方案。
