+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Surgical management of patients with pathologic complete response in the primary tumor after neoadjuvant chemotherapy for rectal cancer



Surgical management of patients with pathologic complete response in the primary tumor after neoadjuvant chemotherapy for rectal cancer



Zhonghua Zhong Liu Za Zhi 37(6): 456-460



To summarize and analyze the clinicopathological features and surgical management of patients with pathologic complete response (pCR) in the primary tumor after neoadjuvant chemotherapy for rectal cancer, and to explore the rational treatment of this entity. Clinical data of fifty-two patients with locally advanced mid-low rectal cancer admitted to the Cancer Institute and Hospital, Chinese Academy of Medical Sciences from January 1994 to December 2013 were retrospectively analyzed. They were treated with neoadjuvant chemotherapy and achieved pathological complete response in the primary tumor. The preoperative clinical staging were stage II (cT3~4N0) in 10 cases and stage III (cT3~4N+) in 42 cases. After the neoadjuvant therapy, 10 cases achieved clinical complete response (cCR) (19.2%). Radical surgery was performed in 51 patients. Among them, five patients (9.8%) had pathological lymph node metastasis. One cCR patient underwent transanal local excision. The postoperative complication rate was 21.2%. During a median follow-up of 23.6 months, only one patient developed bone metastasis and another one had enlarged mesenteric and retroperitoneal lymph nodes detected by imaging. All the patients were alive by the last follow-up. The 2-year disease-free survival rate was 96.2% and overall survival rate was 100%. Radical surgery remains the standard therapy for cCR patients with rectal cancer after neoadjuvant chemotherapy. Local excision and "wait and see" should be recommended with great caution and limited to patients who cannot tolerate or refuse radical surgery with a strong demanding for sphincter saving, or applied in clinical trials.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 058941973

Download citation: RISBibTeXText

PMID: 26463151


Related references

Association of Adjuvant Chemotherapy With Overall Survival in Patients With Rectal Cancer and Pathologic Complete Response Following Neoadjuvant Chemotherapy and Resection. JAMA Oncology 4(7): 938-943, 2018

Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. Journal of Clinical Oncology 17(2): 460-469, 1999

Adjuvant chemotherapy in patients with rectal cancer achieving pathologic complete response after neoadjuvant chemoradiation and surgery. European Journal of Cancer 108: 97-99, 2019

A nomogram to predict pathologic complete response (pCR) and the value of tumor-infiltrating lymphocytes (TILs) for prediction of response to neoadjuvant chemotherapy (NAC) in breast cancer patients. Breast Cancer Research and Treatment 173(2): 255-266, 2019

Evaluation of tumor stiffness by elastography is predictive for pathologic complete response to neoadjuvant chemotherapy in patients with breast cancer. Annals of Surgical Oncology 19(9): 3042-3049, 2012

Long-term outcome of patients with complete pathologic response after neoadjuvant chemoradiation for cT3 rectal cancer: implications for local excision surgical strategies. Annals of Surgical Oncology 18(13): 3686-3693, 2011

Tumor Biology Predicts Pathologic Complete Response to Neoadjuvant Chemotherapy in Patients Presenting with Locally Advanced Breast Cancer. Annals of Surgical Oncology 24(13): 3896-3902, 2017

Baseline tumor oxygen saturation correlates with a pathologic complete response in breast cancer patients undergoing neoadjuvant chemotherapy. Cancer Research 72(17): 4318-4328, 2012

Debating the Optimal Approach to Nodal Management After Pathologic Complete Response to Neoadjuvant Chemotherapy in Patients With Breast Cancer. American Society of Clinical Oncology Educational Book. American Society of Clinical Oncology. Annual Meeting 39: 42-48, 2019

Effect of neoadjuvant chemotherapy regimen on relapse-free survival among patients with breast cancer achieving a pathologic complete response: an early step in the de-escalation of neoadjuvant chemotherapy. Breast Cancer Research 20(1): 27, 2018

Principle of surgical management for rectal cancer patients with complete clinical response after neoadjuvant therapy. Zhonghua Wei Chang Wai Ke Za Zhi 22(4): 342-348, 2019

Magnetic Resonance Imaging Combined With Second-look Ultrasonography in Predicting Pathologic Complete Response After Neoadjuvant Chemotherapy in Primary Breast Cancer Patients. Clinical Breast Cancer 19(1): 71-77, 2019

Surgical complications and pathologic complete response after neoadjuvant chemoradiation in locally advanced rectal cancer. American Surgeon 77(10): 1281-1285, 2011

Pathologic features of breast cancer associated with complete response to neoadjuvant chemotherapy: importance of tumor necrosis. American Journal of Surgical Pathology 29(3): 354-358, 2005

Tumor Volume Reduction Rate Predicts Pathologic Tumor Response of Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemotherapy alone: Results from a Prospective Trial. Journal of Cancer 6(7): 636-642, 2015