Pathological Response after Chemoradiation for T3 Rectal Cancer.
Chennupati SK, Kamaya A, Fisher GA, Ford JM, Kunz P, Itakura H, Welton ML, Shelton A, Van Dam J, Koong AC, Chang DT. Colorectal Dis. 2009
Introduction: To investigate the effect of preoperative chemoradiotherapy (CRT) on nodal disease in locally advanced rectal adenocarcinoma. Methods: Thirty-two patients staged uT3N0 and 27 patients staged uT3N1 rectal adenocarcinoma who underwent pre-CRT staging using endoscopic ultrasound or rectal protocol CT were included. The median radiation dose was 50.4 Gy (range: 45 - 50.4 Gy) at 1.8 Gy per fraction and all patients received concurrent 5-FU or capecitabine based chemotherapy. Low anterior resection or abdomino-perineal resection occurred at a median of 46 days (range: 27 - 112 days) after CRT. Results: Eleven of 32 uT3N0 patients (34.4%) and 13 of 26 uT3N1 patients (50.0%) had ypN+ (p=0.29). For patients with uT3N0, 10 of 20 (50.0%) with ypT2-3 and 1 of 12 (8.3%) with ypT0-1 were ypN+ (p=0.02). For patients with uT3N1, 12 of 20 (60.0%) with ypT2-3 and 1 of 6 (16.7%) with ypT0-1 were ypN+ (p=0.16). Overall, the ypN+ rate was 11.1% in the ypT0-yT1 group compared to 55.0% in the ypT2-yT3 group (p=.003). Among patients with uT3N0 disease, the ypN+ rate in patients who had surgery >46 days versus 46 days versus 46 days versus
PubMedID: 19614668

Jacques Van Dam, M.D., Ph.D.