Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression?
Background: Pathological complete response following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer is associated with reduced local recurrence and improved long-term outcome. However, the prognostic value of a partial response, or of tumour regression in patients with metast...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Published: |
2015
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| Online Access: | http://hdl.handle.net/20.500.11937/6041 |
| _version_ | 1848744963506962432 |
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| author | McCoy, M. Hemmings, C. Hillery, S. Penter, C. Bulsara, M. Zeps, Nikolajs Platell, C. |
| author_facet | McCoy, M. Hemmings, C. Hillery, S. Penter, C. Bulsara, M. Zeps, Nikolajs Platell, C. |
| author_sort | McCoy, M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Pathological complete response following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer is associated with reduced local recurrence and improved long-term outcome. However, the prognostic value of a partial response, or of tumour regression in patients with metastatic disease, is less clear. Methods: We present a single-centre cohort study of 205 patients with stage II–IV rectal cancer treated with surgery and neoadjuvant CRT between 2006 and 2013. Tumour regression was assessed using the Dworak system. Results: The probability of 3-year recurrence-free survival (RFS) was 95% for Dworak grade 4, 82% for grade 3, 64% for grade 2 and 53% for grade 1 (P = 0.0005). In univariate regression analysis, Dworak grade was associated with RFS (hazard ratio (HR) 0.51, P < 0.0001; trend analysis) and cancer-specific survival (HR 0.52, P = 0.002). In multivariate analysis, Dworak grade remained an independent predictor of RFS (HR 0.62, P = 0.012), along with clinical metastases stage, resection margin status, the presence or absence of extramural venous invasion and type of surgical procedure. Conclusions: Tumour regression grade after neoadjuvant CRT was an independent prognostic factor for RFS, highlighting the importance of the degree of local response to CRT. |
| first_indexed | 2025-11-14T06:09:49Z |
| format | Journal Article |
| id | curtin-20.500.11937-6041 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:09:49Z |
| publishDate | 2015 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-60412018-01-03T08:24:16Z Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? McCoy, M. Hemmings, C. Hillery, S. Penter, C. Bulsara, M. Zeps, Nikolajs Platell, C. Background: Pathological complete response following neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer is associated with reduced local recurrence and improved long-term outcome. However, the prognostic value of a partial response, or of tumour regression in patients with metastatic disease, is less clear. Methods: We present a single-centre cohort study of 205 patients with stage II–IV rectal cancer treated with surgery and neoadjuvant CRT between 2006 and 2013. Tumour regression was assessed using the Dworak system. Results: The probability of 3-year recurrence-free survival (RFS) was 95% for Dworak grade 4, 82% for grade 3, 64% for grade 2 and 53% for grade 1 (P = 0.0005). In univariate regression analysis, Dworak grade was associated with RFS (hazard ratio (HR) 0.51, P < 0.0001; trend analysis) and cancer-specific survival (HR 0.52, P = 0.002). In multivariate analysis, Dworak grade remained an independent predictor of RFS (HR 0.62, P = 0.012), along with clinical metastases stage, resection margin status, the presence or absence of extramural venous invasion and type of surgical procedure. Conclusions: Tumour regression grade after neoadjuvant CRT was an independent prognostic factor for RFS, highlighting the importance of the degree of local response to CRT. 2015 Journal Article http://hdl.handle.net/20.500.11937/6041 10.1111/ans.13394 restricted |
| spellingShingle | McCoy, M. Hemmings, C. Hillery, S. Penter, C. Bulsara, M. Zeps, Nikolajs Platell, C. Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| title | Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| title_full | Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| title_fullStr | Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| title_full_unstemmed | Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| title_short | Neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| title_sort | neoadjuvant chemoradiotherapy for rectal cancer: how important is tumour regression? |
| url | http://hdl.handle.net/20.500.11937/6041 |