Low rectal cancer: what factors impair DFS?

  • Souadka A & al.
  • BMC Cancer
  • 28 Oct 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
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Takeaway

  • Patients with low rectal cancer are at greater risk for impaired DFS, even after complete pathological response (CPR) to neoadjuvant chemoradiotherapy (nCRT), if they have poorly differentiated tumors or perineal sepsis.

Why this matters

  • Clinicians and their patients should consider additional, aggressive therapeutic options to mitigate these risk factors.

Study design

  • Researchers studied the health records of patients with low rectal adenocarcinoma who achieved CPR (ypT0N0) after nCRT and total mesorectal excision (N=84; mean age, 54.5±12 years; women, 54.8%), exploring factors linked to DFS.
  • Funding: None.

Key results

  • The overall recurrence rate among patients with CPR was 12.6%.
  • Multivariate analysis showed 2 factors were independently associated with impaired DFS:
    • Poorly differentiated tumors (OR, 9.23; P=.023).
    • Perineal sepsis (OR, 13.51; P=.008).
  • The 30-day mortality rate was 3.6%, and the global complication rate (Clavien-Dindo score ≥IIIa) was 14.3%.

Limitations

  • The study was retrospective with a small sample size.
  • Radiotherapy protocols differed between centers.