Predictors of pathologic complete response after neoadjuvant treatment for rectal cancer: A multicenter study.
2014; Lippincott Williams & Wilkins; Volume: 32; Issue: 3_suppl Linguagem: Inglês
10.1200/jco.2014.32.3_suppl.397
ISSN1527-7755
AutoresDawn Elizabeth Armstrong, Soundouss Raissouni, Julie A. Price Hiller, Jamison Mercer, Erin Powell, Anthony R. MacLean, Di Jiang, Corinne Doll, Rachel Goodwin, Eugene Batuyong, Kevin C. Zhou, Jose Gerard Monzon, Patricia A. Tang, Daniel Yick Chin Heng, Winson Y. Cheung, Michael M. Vickers,
Tópico(s)Cancer, Lipids, and Metabolism
Resumo397 Background: Pathologic complete response (pCR) to neoadjuvant chemoradiation (CRT) for rectal cancer is associated with better long-term outcomes, and is used as an early indicator of response to novel agents. To assess the rate and predictors of pCR, we performed a retrospective population based study in four Canadian provinces. Methods: Cancer Registries identified consecutive patients with clinical stage I-III rectal cancer from the Tom Baker Cancer Center, Cross Cancer Institute, BC Cancer Agency, Ottawa Hospital Cancer Centre and the Dr. H. Bliss Murphy Cancer Centre who received fluoropyrimidine-based CRT and had curative intent surgery (Sx) from 2005 to 2012. Patient, tumor, and therapy characteristics were correlated with response. Results: Of the 891 patients included, 885 patients had pCR data available. 161 (18.2%) had a pCR to CRT, while 724 (81.8%) did not. Patients with a pCR had a lower pre-treatment (tx) CEA, and higher hemoglobin on univariate analysis (see table). On multivariable analysis, statin use at baseline (OR 1.7, 95% CI 1.04-2.89, p=0.044), lower pre-tx CEA (OR 1.03, 95% CI 1.003-1.05 p=0.028) and distance closer to anal verge (OR 1.07, 95% CI 1.004-1.15, p=0.039) were significant predictors of pCR. The 3yr DFS was 86% in those with pCR vs 62.5% in those without a pCR (P<0.0001). Conclusions: Lower pre-tx CEA, distance closer to anal verge and statin use are predictors of pCR. Clinical trials investigating statins combined with neoadjuvant CRT may be warranted. [Table: see text]
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