Complete Response after Neoadjuvant Therapy in Rectal Cancer- Does T0 Mean N0?
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 11
Abstract
Introduction: Rectal resection after neoadjuvant chemoradiotherapy is the standard of care for rectal cancer. Non-operative management of rectal cancer is the new frontier. Selection of these patients is based on the absence of mucosal disease after neoadjuvant therapy. The question that is quintessential is whether absence of mucosal disease means absence of nodal disease. Aim: To see the correlation between absence of mucosal disease and mesorectal disease in rectal resections after neoadjuvant therapy for rectal cancer. Materials and Methods: A retrospective study was done on 479 patients of locally advanced carcinoma rectum from 2008 to 2015. All patients received neoadjuvant therapy which was mainly long course radiation therapy with 5040cGy over duration of 28 days with concurrent chemotherapy. Some patients underwent neoadjuvant chemotherapy. After an interval of approximately 6 weeks they underwent curative surgery. The patients who had complete pathological response were analysed in this study. Results: Out of the 479 patients, 76 patients were found to have no disease in the rectal wall. Only 1 patient (1.3%) had node positive disease without having any rectal disease (T0N1). The rest had no tumour either in the rectum or the mesorectal nodes. Thus, 75 patients had a pathological complete response (15.6%). Conclusion: In patients with rectal cancer undergoing neoadjuvant chemoradiotherapy followed by radical resection, absence of tumour in the rectum correlates well with absence of disease in the mesorectum and absence of nodal disease. Thus, absence of mucosal disease can be taken as marker of complete response to neoadjuvant therapy
Authors and Affiliations
Rajat Raghunath, Dipti Masih, Rajesh Joseph Selvakumar, Bharat Shankar, Mark Ranjan Jesudason
Keywords
Related Articles
- EP ID EP366495
- DOI 10.7860/JCDR/2017/30848.10842
- Views 65
- Downloads 0
Comparison of Steroid and Itraconazole for Prevention of Recurrence in Allergic Fungal Rhinosinusitis: A Randomized Controlled Trial
Introduction: Allergic Fungal Rhinosinusitis (AFRS) is due to the continuous exposure of fungal antigens to an atopic individual. Medical treatment following the surgery is the standard protocol often practiced for the t...
Does Change in Thread Shape Influence the Pull Out Strength of Mini Implants? An In vitro Study
Introduction: Mini implants form a valuable source for absolute anchorage thereby helping in achieving ideal treatment outcome. Stability of the mini implant is one of the important factors affecting the success of mini...
Radiological Features of Thalassaemia-An Update
ABSTRACT Thalassaemia is an inherited disorder of haemoglobin synthesis which causes different craniofacial defects. The clinical features results from anaemia and also iron transfusion therapy. This article presents ske...
Evaluation of Dental Non-Metric Traits in Ethnic Tamil Population: An Aid in Forensic Profiling
ABSTRACT Introduction: Non-metric dental traits are features of dental morphology that show alteration in their appearance both within and between the populations. These traits seem to be controlled in part by genetics...
Golden Hours in Severe Paraquat Poisoning-The Role of Early Haemoperfusion Therapy
Introduction: Paraquat is a commonly ingested poison especially in Southern India. There is no antidote for paraquat poison and consumption is often fatal. The usual cause of death is either acute lung injury or multi-or...