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Predicting tumor response after preoperative chemoradiation using clinical parameters in rectal cancer

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Author(s): Chan Ho Park | Hee Cheol Kim | Yong Beom Cho | Seong Hyeon Yun | Woo Yong Lee | Young Suk Park | Doo Ho Choi | Ho-Kyung Chun

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 17;
Issue: 48;
Start page: 5310;
Date: 2011;
Original page

Keywords: Rectal cancer | Preoperative chemoradiotherapy | Downstaging | Tumor regression | Validation

ABSTRACT
AIM: To evaluate the clinical parameters and identify a better method of predicting pathological complete response (pCR). METHODS: We enrolled 249 patients from a database of 544 consecutive rectal cancer patients who underwent surgical resection after preoperative chemoradiation therapy (PCRT). A retrospective review of morphological characteristics was then performed to collect data regarding rectal examination findings. A scoring model to predict pCR was then created. To validate the ability of the scoring model to predict complete regression. RESULTS: Seventy patients (12.9%) achieved a pCR. A multivariate analysis found that pre-CRT movability (P = 0.024), post-CRT size (P = 0.018), post-CRT morphology (P = 0.023), and gross change (P = 0.009) were independent predictors of pCR. The accuracy of the scoring model was 76.8% for predicting pCR with the threshold set at 4.5. In the validation set, the accuracy was 86.7%. CONCLUSION: Gross changes and morphological findings are important predictors of pathological response. Accordingly, PCRT response is best predicted by a combination of clinical, laboratory and metabolic information.
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